Inhibition of MCL-1 and/or BFL-1/A1

ABSTRACT

This disclosure features compounds and pharmaceutically acceptable salts thereof that inhibit MCL-1 and/or BFL-1/A1 and compositions containing the same. This disclosure also features combinations that include one or more of the MCL-1/BFL-1/A1 inhibitor compounds described herein, or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-XL, BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-XL; e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the one or more therapeutic agents (as well as compositions containing the same). Also featured are methods of using such compounds, salts, combinations, and compositions, e.g., for the treatment or prevention of diseases, disorders, and conditions associated with deregulated apoptosis of cells (e.g., diseased or damaged cells; e.g., insufficient apoptosis of diseased or damaged cells or reduced apoptosis of diseased or damaged cells).

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No. 61/613,225, filed on Mar. 20, 2012, which is incorporated herein by reference in its entirety.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

This invention was made with government support under grant number CA092625 awarded by The National Institutes of Health. The government has certain rights in the invention.

TECHNICAL FIELD

This disclosure features compounds and pharmaceutically acceptable salts thereof that inhibit MCL-1 and/or BFL-1/A1 and compositions and combinations containing the same as well as methods of using the same.

BACKGROUND

BCL-2 is the founding member of a family of anti- and pro-apoptotic proteins that form an interaction network to regulate the critical homeostatic balance between cellular life and death^(1,2). The original discovery of BCL-2 at the t(14;18) chromosomal breakpoint of follicular lymphoma expanded the paradigm for cancer pathogenesis to include the inability to undergo programmed cell death³⁻⁵. The pathologic overexpression of anti-apoptotic BCL-2 and its functional homologues BCL-X_(L), BCL-w, MCL-1, and BFL-1/A1 has emerged as a causative mechanism for the development, maintenance, and chemoresistance of many human cancers^(6,7).

The anti-apoptotic proteins contain a surface groove that can bind and sequester—with differential potency and specificity—the BH3 death domains of pro-apoptotic members^(8,9). BH3-only pro-apoptotics such as BID and BIM contain a single BH3 domain and function as afferent sensors of cellular stress, delivering their death message to the “multidomain” anti- and pro-apoptotic members, which regulate the cellular life-death decision at the level of the mitochondrion¹⁰. When activated directly by BH3-only interaction and/or indirectly by BH3-only-mediated competitive displacement from anti-apoptotics, the multidomain pro-apoptotic proteins BAX and BAK undergo a monomer-to-oligomer transformation that results in outer mitochondrial membrane poration and release of apoptogenic factors¹¹. Whereas cancer cells deploy the anti-apoptotic proteins to silence this pro-apoptotic pathway, pharmacologic antagonists of anti-apoptotic proteins hold promise to restore the death pathway in cancer. Thus, a series of small molecule screens and structure-based methodologies were initially applied to target BCL-2, yielding an eclectic array of small molecules and peptides with various degrees of biochemical, cellular, and in vivo activity¹²⁻²¹. ABT-263 is an orally bioavailable and selective BCL-2/BCL-X_(L) inhibitor, which is advancing through the clinical trials process, manifesting both safety and preliminary efficacy in BCL-2-dependent cancers²²⁻²⁵.

Broad experimentation with the ABT-263 molecule and its progenitor ABT-737 revealed that expression of anti-apoptotic proteins lying outside their binding spectra caused resistance²⁶⁻²⁹, compelling the development of alternative or complementary agents that would either harbor broader anti-apoptotic targeting capacity or inherent selectivity for anti-apoptotics like MCL-1 and BFL-1/A1 that evade ABT-263/737 antagonism. The small molecule obatoclax¹⁵ and the peptidic Stabilized Alpha-Helix of BCL-2 domains (SAHBs) modeled after the BID and BIM BH3 domains³⁰⁻³² are examples of novel agents that more broadly target the BCL-2 family anti-apoptotic proteins.

WO 2011/094708 discloses small molecules that modulate MCL-1 and/or BFL-1/A1 and methods of using the same, as a single agent or in combination with other drugs, for modulating cell death, cell division, cell differentiation, and treating disorders, such as hyperproliferative disorders.

SUMMARY I

This disclosure features compounds and pharmaceutically acceptable salts thereof that inhibit MCL-1 and/or BFL-1/A1 and compositions containing the same. This disclosure also features combinations that include one or more of the MCL-1/BFL-1/A1 inhibitor compounds described herein, or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the one or more therapeutic agents (as well as compositions containing the same).

Also featured are methods of using any one or more of such MCL-1 and/or BFL-1/A1 inhibitor compounds, salts, combinations, and compositions, alone or in combination with other drugs e.g., for the treatment or prevention of diseases, disorders, and conditions associated with deregulated apoptosis of cells (e.g., diseased or damaged cells; e.g., insufficient apoptosis of diseased or damaged cells or reduced apoptosis of diseased or damaged cells) and/or other cancer treatment therapies (e.g., surgery, radiation).

In one aspect, this disclosure features combinations that include one or more compounds of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737); or (where applicable) a pharmaceutically acceptable salt of the one or more therapeutic agents (as well as compositions containing the same).

Compounds of formula (I) have the following formula:

in which:

R²² is aryl, heteroaryl, cycloalkyl, heterocycloalkyl; each of which is optionally substituted with from 1-5 (e.g., 1-3) independently selected Z;

R²³ is C₁-C₈ alkyl, C₁-C₈ haloalkyl C₂-C₈ alkenyl, C₂-C₈ alkynyl, C₁-C₆ alkoxy, or C₁-C₆ haloalkoxy; or substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted cycloalkyl, or substituted or unsubstituted heterocycloalkyl wherein when R²³ is substituted, it is substituted with from 1-5 (e.g., 1-3) independently selected Z; and

R²⁴ is C₁-C₈ alkyl, C₁-C₈ haloalkyl C₂-C₈ alkenyl, C₂-C₈ alkynyl, C₁-C₆ alkoxy, or C₁-C₆ haloalkoxy; or substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted cycloalkyl, or substituted or unsubstituted heterocycloalkyl wherein when R²⁴ is substituted, it is substituted with from 1-5 (e.g., 1-3) independently selected Z; and

each occurrence of Z is independently halogen; hydroxyl; oxo (except when R²²-R²⁴ is aromatic); C₁-C₈ alkyl; C₁-C₈ haloalkyl; C₂-C₈ alkenyl; C₂-C₈ alkynyl; C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; or phenyl, heteroaryl, cycloalkyl, or heterocycloalkyl. Each of which is optionally substituted with from 1-3 substituents independently selected from halogen; hydroxyl; oxo (except when R²²-R²⁴ is aromatic); C₁-C₈ alkyl; C₁-C₈ haloalkyl; C₂-C₈ alkenyl; C₂-C₈ alkynyl; C₁-C₆ alkoxy; C₁-C₆ haloalkoxy.

Compounds of formula (II) have the following formula:

wherein:

R²² is:

(i) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(a);

(ii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(a); or

(iii) phenyl fused to C₁-C₃ alkylenedioxy, wherein the phenyl portion is optionally substituted with from 1-2 independently selected R^(a);

R²³ is:

(i) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(ii) phenyl that is optionally substituted with from independently selected 1-4 R^(c);

(iii) heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from 1-3 independently selected R^(c);

(iv) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

or

R²³ and R²⁵, together with the carbon atoms to which each is attached, form:

(i) a 5-6 membered saturated or unsaturated carbocyclic ring, which is optionally substituted with from 1-4 independently selected R^(d); or

(ii) a 5-6 membered saturated or unsaturated hetrocyclic ring, which is optionally substituted with from 1-4 independently selected R^(d), and wherein from 1-2 of the ring atoms (other than the two ring atoms attached to R²³ and R²⁴) is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S;

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached); or

each of R²⁶ and R²⁷ is independently selected from hydrogen, halo, and hydroxyl;

R²⁴ is:

(i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c);

(iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c);

(iv) unsubstituted C₁-C₈ alkyl or unsubstituted C₁-C₈ haloalkyl;

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

(vi) (C₁-C₆ alkyl)-(C₃-C₈ cycloalkyl), wherein the cycloalkyl portion is optionally substituted with from 1-4 independently selected R^(d); or

(vii) dihydronaphthyl, tetrahydronaphthyl, indanyl, or indenyl;

R^(a) at each occurrence is, independently, selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂;

R^(b) at each occurrence is, independently, selected from hydroxyl, C₁-C₆ alkoxy; C₁-C₆ thioalkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NH₂; —NH(C₁-C₆ alkyl); N(C₁-C₆ alkyl)₂; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂;

R^(c) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a), (b), (c), and (d) below:

(a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH;

(b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl); —C(O)O—(CH₂)_(1-3(e.g., 1))—C(O)-(phenyl optionally substituted as defined in (d) below (e.g., —C(O)O—CH₂—C(O)-(phenyl);

(c) L-C₃-C₈ cycloalkyl, C₃-C₆ cycloalkoxy, or L-heterocyclyl containing from 5-7 ring atoms, wherein from 1-2 of the ring atoms of the heterocyclyl is independently selected from N, NH, N(C₁-C₆ alkyl), NC(O)(C₁-C₆ alkyl), NC(O)O(C₁-C₆ alkyl), O, and S; and each of said ring systems is optionally substituted with from 1-3 independently selected C₁-C₄ alkyl groups; and wherein L is a bond or C₁-C₆ alkylene; and

(d) phenyl, —O-(phenyl), or heteroaryl containing from 5-6 ring atoms, wherein from 1-2 of the ring atoms of the heteroaryl is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; wherein each of said phenyl and heteroaryl is optionally substituted with from 1-3 substituents independently selected from halo; hydroxyl; cyano; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); nitro; —NH₂; —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, —NHC(O)(C₁-C₆ alkyl), C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, and C₁-C₆ haloalkyl, wherein said alkyl or alkyl portion is optionally substituted with —OH, —NH₂, or —SH;

R^(d) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a) and (b) below:

(a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; or

(b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl).

In some embodiments, it is provided when R²⁵ is hydrogen, and R²⁶ and R²⁷ together are a bond, then one, or more, or all of the following apply:

(1) R²⁴ cannot be unsubstituted cyclohexyl when R²² is 2,3,4-trihydroxyphenyl, and R²³ is CH₃;

(2) R²⁴ cannot be 4-fluorophenyl when R²² is 3,4-dihydroxyphenyl, and R²³ is 2H-benzo[b][1,4]oxazinyl-3 (4H)-onyl;

(3) R²⁴ cannot be 2,4-difluorophenyl when R²² is 2,4-dihydroxyphenyl, and R²³ is furyl;

(4) R²⁴ cannot be 3-pyridyl when R²² is 2,4-dihydroxyphenyl, and R²³ is furyl;

(5) when R²² is 2,3,4-trihydroxyphenyl, then: R²⁴ cannot be CH₃ when R²³ is CH₃, 3,4-dimethylphenyl, 2-fluorophenyl, thienyl, or 3,4-dichlorophenyl; and R²⁴ cannot be n-propyl when R²³ is CH₃; and R²⁴ cannot be iso-propyl when R²³ is thienyl; and R²⁴ cannot be ethyl when R²³ is CH₃,

(6) R²³ and R²⁴ cannot both be CH₃ when R²² is 2,4-dihydroxyphenyl, 3,4-dihydroxyphenyl, 2-iodophenyl, 4-hydroxyphenyl, 4-cyanophenyl, or benzo[d][1,3]dioxolyl;

(7) R²³ cannot be 4-(difluoromethoxy)phenyl when R²² is 4-hydroxyphenyl or 4-ethoxyphenyl, and R²⁴ is CH₃; and

(8) R²³ cannot be 2-fluorophenyl or furyl when R²² is 3,4-dihydroxyphenyl, and R²⁴ is CH₃.

In another aspect, compounds having formula (II), or a pharmaceutically acceptable salt thereof, are featured:

wherein:

R²² is:

(i) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(a);

(ii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(a); or

(iii) phenyl fused to C₁-C₃ alkylenedioxy, wherein the phenyl portion is optionally further substituted with from 1-2 independently selected R^(a);

R²³ is:

(i) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) branched C₃-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); or

(iii) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

R²⁴ is:

(i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c);

(iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c);

(iv) unsubstituted C₁-C₈ alkyl or unsubstituted C₁-C₈ haloalkyl; or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

R^(a) at each occurrence is, independently, selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂;

R^(b) at each occurrence is, independently, selected from hydroxyl, C₁-C₆ alkoxy; C₁-C₆ thioalkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NH₂; —NH(C₁-C₆ alkyl); N(C₁-C₆ alkyl)₂; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂;

R^(c) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a), (b), (c), and (d) below:

(a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH;

(b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl); —C(O)O—(CH₂)_(1-3 (e.g., 1))—C(O)-(phenyl optionally substituted as defined in (d) below (e.g., —C(O)O—CH₂—C(O)-(phenyl);

(c) L-C₃-C₈ cycloalkyl, C₃-C₆ cycloalkoxy, or L-heterocyclyl containing from 5-7 ring atoms, wherein from 1-2 of the ring atoms of the heterocyclyl is independently selected from N, NH, N(C₁-C₆ alkyl), NC(O)(C₁-C₆ alkyl), NC(O)O(C₁-C₆ alkyl), O, and S; and each of said ring systems is optionally substituted with from 1-3 independently selected C₁-C₄ alkyl groups; and wherein L is a bond or C₁-C₆ alkylene; and

(d) phenyl, —O-(phenyl), or heteroaryl containing from 5-6 ring atoms, wherein from 1-2 of the ring atoms of the heteroaryl is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; wherein each of said phenyl and heteroaryl is optionally substituted with from 1-3 substituents independently selected from halo; hydroxyl; cyano; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); nitro; —NH₂; —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, —NHC(O)(C₁-C₆ alkyl), C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, and C₁-C₆ haloalkyl, wherein said alkyl or alkyl portion is optionally substituted with —OH, —NH₂, or —SH; and

R^(d) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a) and (b) below:

(a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; or

(b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl).

In a further aspect, compounds having formula (II), or a pharmaceutically acceptable salt thereof, are featured:

wherein:

R²² is:

(i) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(a);

(ii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(a); or

(iii) phenyl fused to C₁-C₃ alkylenedioxy, wherein the phenyl portion is optionally substituted with from 1-2 independently selected R^(a);

R²³ is:

(i) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(ii) phenyl that is optionally substituted with from independently selected 1-4 R^(c);

(iii) heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from independently selected 1-3 R^(c); or

(iv) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

R²⁴ is:

(i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(ii) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

R^(a) at each occurrence is, independently, selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂;

R^(b) at each occurrence is, independently, selected from hydroxyl, C₁-C₆ alkoxy; C₁-C₆ thioalkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NH₂; —NH(C₁-C₆ alkyl); N(C₁-C₆ alkyl)₂; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂;

R^(c) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a), (b), (c), and (d) below:

(a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH;

(b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl); —C(O)O—(CH₂)_(1-3(e.g., 1))-C(O)-(phenyl optionally substituted as defined in (d) below (e.g., —C(O)O—CH₂—C(O)-(phenyl);

(c) L-C₃-C₈ cycloalkyl, C₃-C₆ cycloalkoxy, or L-heterocyclyl containing from 5-7 ring atoms, wherein from 1-2 of the ring atoms of the heterocyclyl is independently selected from N, NH, N(C₁-C₆ alkyl), NC(O)(C₁-C₆ alkyl), NC(O)O(C₁-C₆ alkyl), O, and S; and each of said ring systems is optionally substituted with from 1-3 independently selected C₁-C₄ alkyl groups; and wherein L is a bond or C₁-C₆ alkylene; and

(d) phenyl, —O-(phenyl), or heteroaryl containing from 5-6 ring atoms, wherein from 1-2 of the ring atoms of the heteroaryl is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; wherein each of said phenyl and heteroaryl is optionally substituted with from 1-3 substituents independently selected from halo; hydroxyl; cyano; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); nitro; —NH₂; —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, —NHC(O)(C₁-C₆ alkyl), C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, and C₁-C₆ haloalkyl, wherein said alkyl or alkyl portion is optionally substituted with —OH, —NH₂, or —SH;

R^(d) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a) and (b) below:

(a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; or

(b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl).

In some embodiments, it is provided when R²⁵ is hydrogen, R²⁴ cannot be unsubstituted cyclohexyl when R²² is 2,3,4-trihydroxyphenyl, and R²³ is CH₃.

In still another aspect, compounds having formula (II), or a pharmaceutically acceptable salt thereof, are featured:

wherein:

R²² is C₆-C₁₀ aryl, which is substituted with three hydroxyl groups and optionally further substituted with from 1-2 independently selected R^(a);

R²³ is:

(i) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(ii) phenyl that is optionally substituted with from independently selected 1-4 R^(c);

(iii) heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from independently selected 1-3 R^(c);

(iv) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

R²⁴ is:

(i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c);

(iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c); or

(iv) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

R^(a) at each occurrence is, independently, selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂;

R^(b) at each occurrence is, independently, selected from hydroxyl, C₁-C₆ alkoxy; C₁-C₆ thioalkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NH₂; —NH(C₁-C₆ alkyl); N(C₁-C₆ alkyl)₂; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂;

R^(c) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a), (b), (c), and (d) below:

(a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH;

(b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl); —C(O)O—(CH₂)_(1-3(e.g., 1))—C(O)-(phenyl optionally substituted as defined in (d) below (e.g., —C(O)O—CH₂—C(O)-(phenyl);

(c) L-C₃-C₈ cycloalkyl, C₃-C₆ cycloalkoxy, or L-heterocyclyl containing from 5-7 ring atoms, wherein from 1-2 of the ring atoms of the heterocyclyl is independently selected from N, NH, N(C₁-C₆ alkyl), NC(O)(C₁-C₆ alkyl), NC(O)O(C₁-C₆ alkyl), O, and S; and each of said ring systems is optionally substituted with from 1-3 independently selected C₁-C₄ alkyl groups; and wherein L is a bond or C₁-C₆ alkylene; and

(d) phenyl, —O-(phenyl), or heteroaryl containing from 5-6 ring atoms, wherein from 1-2 of the ring atoms of the heteroaryl is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; wherein each of said phenyl and heteroaryl is optionally substituted with from 1-3 substituents independently selected from halo; hydroxyl; cyano; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); nitro; —NH₂; —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, —NHC(O)(C₁-C₆ alkyl), C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, and C₁-C₆ haloalkyl, wherein said alkyl or alkyl portion is optionally substituted with —OH, —NH₂, or —SH;

R^(d) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a) and (b) below:

(a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; or

(b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl).

In some embodiments, it is provided when R²⁵ is hydrogen, then:

(1) R²⁴ cannot be unsubstituted cyclohexyl when R²² is 2,3,4-trihydroxyphenyl, and R²³ is CH₃;

(2) R²⁴ cannot be 4-fluorophenyl when R²² is 3,4-dihydroxyphenyl, and R²³ is 2H-benzo[b][1,4]oxazinyl-3 (4H)-onyl;

(3) R²⁴ cannot be 2,4-difluorophenyl when R²² is 2,4-dihydroxyphenyl, and R²³ is furyl; and

(4) R²⁴ cannot be 3-pyridyl when R²² is 2,4-dihydroxyphenyl, and R²³ is furyl.

The compounds, salts, combinations, and compositions described herein are therapeutically useful for treating (e.g., controlling, relieving, ameliorating, alleviating, or slowing the progression of) or preventing (e.g., delaying the onset of or reducing the risk of developing) diseases, disorders, and conditions associated with deregulated apoptosis of cells (e.g., diseased or damaged cells; e.g., insufficient apoptosis of diseased or damaged cells; or lack of apoptosis of diseased or damaged cells). Examples of such diseases, disorders, and conditions include (but are not limited to) those associated with blockade(s) of cell death pathways (e.g., over-expression of anti-apoptotic BCL-2 proteins; e.g., over-expression of anti-apoptotic BCL-2 proteins that fall outside of the inhibitory spectrum of a particular anti-apoptotic BCL-2 protein inhibitor, such as ABT-263 or ABT-737). Examples of such diseases, disorders, and conditions include hyperproliferative diseases, such as cancer.

While not wishing to be bound by theory, it is believed that the compounds, salts, combinations, and compositions described herein induce and increase apoptosis in target cells (e.g., pathogenic cells including, but not limited to, cancer cells), thereby suppressing tumor growth and/or proliferation. It is further believed that increasing apoptosis in such target cells reestablishes the normal apoptotic control that, during homeostasis, is associated with a regulated balance between pro- and anti-apoptotic protein functions.

II

In embodiments, the compounds, compositions, combinations, and methods described herein can include any one or more of the features described below throughout sections [A] through [G] below.

[A] In some embodiments, the compound of formula (I) and/or (II) selectively inhibit MCL-1 and/or BFL-1/A1. As used herein, a compound of formula (I) that “selectively inhibits MCL-1 and/or BFL-1/A1” meets at least one of the four performance criteria described in sections [1], [2], [3], and [4] below.

[1] The first performance criteria is that the formula (I) and/or (II) compound exhibits a preference for MCL-1ΔNΔC, as defined both by >50% displacement of the FITC-MCL-1 SAHB_(A)/MCL-1ΔNΔC interaction and a >45% difference in peptide displacement from MCL-1ΔNΔC vs. BCL-X_(L)ΔC. MCL-1 SAHBs are hydrocarbon-stapled MCL-1 BH3 helices that were previously shown using chemical, structural, and biological methods to selectively target MCL-1 and sensitize cancer cells to caspase-dependent apoptosis³⁴. MCL-1 SAHB_(A) is utilized herein as a high fidelity screening tool due to its potency and specificity-of-action. FITC indicates that the stapled peptide is labeled with Fluorescein isothiocyanate. The following two competitive fluorescence polarization (FP) assays are used to evaluate whether a formula (I) compound meets the first performance criteria: (i) a fluorescence polarization (FP) screening assay (Z-factor, 0.62) based on the direct binding interaction between FITC-MCL-1 SAHB_(A) and MCL-1ΔNΔC (EC₅₀, 14 nM) (Figure S1A-C), in which the compound is screened for its capacity to displace FITC-MCL-1 SAHB_(A) from recombinant MCL-1ΔNΔC (aa 172-327); and (ii) a counterscreen using a competitive FP assay (Z-factor, 0.71) developed based on the direct and selective interaction between FITC-BAD BH3 and BCL-X_(L)ΔC (EC₅₀, 26 nM). See Examples section for a description of these assays.

[2] The second performance criteria is that the formula (I) and/or (II) compound competes with FITC-MCL-1 SAHB_(A) for MCL-1ΔNΔC binding at IC₅₀ potencies of <30 μM. The following in vitro binding assays are used to evaluate whether a formula (I) compound meets the second performance criteria: (i) repeat single-dose testing in the differential competitive FP screen (supra); (ii) alternative single-dose selectivity screen of confirmed MCL-1-directed antagonists comparing relative displacement of FITC-BID BH3, a dual binder,³⁵ from MCL-1ΔNΔC vs. BCL-X_(L)ΔC; and then (iii) dose-responsive competitive binding against the FITC-MCL-1 SAHB_(A)/MCL-1ΔNΔC complex. See Examples section for a description of these assays.

[3] The third performance criteria is that the formula (I) and/or (II) compound (i) competes with FITC-MCL-1 SAHB_(A) for MCL-1ΔNΔC binding with an IC₅₀ of less than 10 μM (e.g., less than 5 μM); (ii) competes with FITC-BID BH3 for MCL-1ΔNΔC binding with an IC₅₀ of less than 10 μM (e.g., less than 5 μM); and (iii) exhibits an IC₅₀>50 μM in its capacity to displace FITC-BID BH3 from BCL-X_(L)ΔC (IC₅₀>50 μM). See Examples section for a description of these assays.

[4]A fourth performance criteria is that the formula (I) and/or (II) compound competes with FITC-BID BH3 for BFL-1/A1ΔC binding with an IC₅₀ of less than 10 μM (e.g., less than 5 μM); and (iii) exhibits an IC₅₀>50 μM in its capacity to displace FITC-BID BH3 from BCL-X_(L)ΔC (IC₅₀>50 μM). See Examples section for a description of these assays. Compounds of the formula (I) and/or (II) compound may fulfill performance criteria 1-3 (selective MCL-1 targeting), 1-4 (selective MCL-1 and BFL-1/A1 targeting), or 4 (selective BFL-1/A1 targeting).

[5] Accordingly, in another aspect, methods for identifying selective MCL-I and BFL-1/A1 binding agents are featured, which include contacting an MCL-I and/or BFL-1/A1 polypeptide bound to an MCL-1 or BFL-1/A1-binding BH3 peptide or SAHB with a test compound under conditions suitable for interaction of the test compound with the MCL-I and/or BFL-1/A1 polypeptide; and detecting dissociation of the BH3 peptide or SAHB from the MCL-1 and/or BFL-1/A1 polypeptide, where detection of such dissociation identifies a test compound as a selective MCL-1 and/or BFL-1/A1 binding agent. In another embodiment, the MCL-1 and/or BFL-1/A1 binding agent is a selective MCL-1 inhibitor, selective MCL-1 and BFL-1/A1 inhibitor, or a selective BFL-1/A1 inhibitor. In a further embodiment, the MCL-1 or BFL-1/A1 polypeptide, or, optionally, the BH3 peptide or SAHB, is labeled, e.g., with FITC. In still other embodiments, the methods further include contacting a non-MCL-1 or non-BFL-1/A1, anti-apoptotic BCL-2 family polypeptide bound to an inhibitor of said non-MCL-1 or non-BFL-1/A1, anti-apoptotic BCL-2 family polypeptide with a test compound under conditions suitable for interaction of the test compound with the non-MCL-1 or non-BFL-1/A1, anti-apoptotic BCL-2 family polypeptide; and detecting dissociation (if any) of the inhibitor from the non-MCL-1 or non-BFL-1/A1, anti-apoptotic BCL-2 family polypeptide. Effects that may be observed include, but are not limited to, those described in the Examples section.

[B] The compound of formula (I) can include any one or more of the following features.

In some embodiments, R²² is aryl (e.g., phenyl), which is optionally substituted with from 1-5 (e.g., 1-3) independently selected Z (e.g., hydroxyl). In certain embodiments, R²² is phenyl, which is optionally substituted with from 1-3 hydroxyl groups.

In some embodiments, R²³ is C₁-C₈ (e.g., C₁-C₄) alkyl; e.g., CH₃.

In some embodiments, R²⁴ is unsubstituted cycloalkyl or cycloalkyl (e.g., C₃-C₇) that is substituted with from 1-5 (e.g., 1-3) independently selected Z; e.g., unsubstituted cycloalkyl, e.g., cyclohexyl.

In some embodiments:

R²² is aryl (e.g., phenyl), which is optionally substituted with from 1-5 (e.g., 1-3) independently selected Z (e.g., hydroxyl). In certain embodiments, R²² is phenyl, which is optionally substituted with from 1-3 hydroxyl groups; and

R²³ is C₁-C₈ (e.g., C₁-C₄) alkyl; e.g., CH₃; and

R²⁴ is unsubstituted cycloalkyl or cycloalkyl (e.g., C₃-C₇) that is substituted with from 1-5 (e.g., 1-3) independently selected Z; e.g., unsubstituted cycloalkyl, e.g., cyclohexyl.

In certain embodiments, the compound is:

which is sometimes referred to herein as “MIM1.”

Other exemplary compounds of formula (I) include those disclosed in FIG. 16 (also disclosed in FIG. 4D of WO 2011/094708, which is incorporated herein by reference.

The compounds of formula (II) can include any one or more of the following features as well as any one or more of the features described in the detailed description and/or the claims.

R²⁶ and R²⁷ together are a bond.

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl).

R²² can be C₆-C₁₀ (e.g., C₆) aryl, which is optionally substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a).

R²² can be C₆-C₁₀ (e.g., C₆) aryl, which is substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a).

Each R^(a) can be independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.

Each R^(a) can be independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

One, two, or three (e.g., three) of the independently selected R^(a) can be hydroxyl.

R²² can have formula (A):

wherein:

one, two, or three (e.g., three) of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ are each independently selected R^(a), and the others are hydrogen.

R²² can have formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are each independently selected R^(a), and the others are hydrogen (e.g., each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH; e.g., each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH; e.g., each of the three R^(a) is hydroxyl).

R²⁵ can be hydrogen.

R²⁵ can be a substituent other than hydrogen, such as C₁-C₈ alkyl or C₁—C haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b). For example, R²⁵ can be C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b); e.g., R²⁵ can be unsubstituted C₁-C₈ alkyl (e.g., C₁-C₃ alkyl, e.g., CH₃).

R²³ can be C₃-C₆ cycloalkyl (e.g., cyclopropyl), which is optionally substituted with from 1-4 independently selected R^(d) (e.g., C₁-C₆ alkyl, C₁-C₃ alkyl).

R²³ can be C₁-C₈ (e.g., C₁-C₃, e.g., C₁-C₂, CH₃; C₂-C₈, C₃-C₈, C₄-C₈, tert-butyl) alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

R²³ can be unsubstituted C₁-C₈ alkyl (e.g., unsubstituted C₂-C₈ alkyl, unsubstituted C₃-C₈ alkyl, unsubstituted branched C₃-C₈ alkyl, unsubstituted branched C₄-C₈ alkyl). For example, R²³ is CH₃. As another example, R²³ can be tert-butyl.

In some embodiments, R²⁴ can be C₃-C₁₀ (e.g., C₃-C₈, e.g., C₃-C₆, e.g., C₆) cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

[C] In some embodiments, the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins (e.g., agents that inhibit anti-apoptotic BCL-2 proteins), are selected from ABT-199, ABT-263, ABT-737, obatoclax, gossypol derivatives, IAP inhibitors, and stapled peptides that target anti-apoptotic proteins (MCL-1 SAHB (see, Stewart et al, Nature Chem Biol, 2010), BID SAHB (Walensky et al Science 2004), BAD SAHB (Danial et al Nature Medicine 2008), and BIM SAHB (Gavathiotis et al Nature 2008), etc.). In certain embodiments, the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins are selected from ABT-199, ABT-263 and ABT-737, e.g., ABT-737.

“ABT-263” refers to N-(4-(4-((2-(4-chlorophenyl)-5,5-dimethyl-1-cyclohex-1-en-1-yl)methyl)piperazin-1-yl)benzoyl)-4-(((1R)-3-(morpholin-4-yl)-1-((phenyl-sulfanyl)methyl)propyl)amino)-3-((trifluoromethyl)sulfonyl) benzenesulfonamide.

“ABT-737” refers to N-(4-(4-((4′-chloro(1,1′-biphenyl)-2-yl)methyl)piperazin-1-yl)benzoyl)-4-(((1R)-3-(dimethylamino)-1-((phenylsulfanyl)methyl)propyl)amino)-3-nitrobenzenesulfonamide.

“ABT-199” refers to (Souers et al. Nat Med 2013, 19, p 202-208):

[D] In some embodiments, the compound of formula (I) and/or (II) has an interaction profile that is opposite to the interaction profile of the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins (see, e.g., the difference in interaction profiles between the compound described herein as “MIM1” and that of ABT-737).

In some embodiments, the combination of a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof (e.g., a compound of formula (I) and/or (II) or a salt thereof that selectively inhibits MCL-1 and/or BFL-1/A1), and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737) exhibits greater than additive anti-cancer activity (e.g., greater than additive cancer cell cytotoxicity, e.g., greater than additive leukemia cancer cell cytotoxicity).

In some embodiments:

(i) the compound of formula (I) and/or (II) has an interaction profile that is opposite to the interaction profile of the one or more additional therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic proteins (see, e.g., the difference in interaction profiles between the compound described herein as “MIM1” and that of ABT-737); and

(ii) the combination of a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof (e.g., a compound of formula (I) or a salt thereof that selectively inhibits MCL-1 and/or BFL-1/A1), and one or more additional therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic proteins (e.g., agents that bind to and inhibit anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and BFL-1/A1; e.g., agents that bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-263 and ABT-737; e.g., ABT-737) exhibits greater than additive anti-cancer activity (e.g., greater than additive cancer cell cytotoxicity, e.g., greater than additive leukemia cancer cell cytotoxicity).

[E] In some embodiments, the one or more additional therapeutic agents bind to and inhibit, or indirectly modulate, anti-apoptotic proteins.

In some embodiments, the one or more additional therapeutic agents directly activate pro-apoptotic proteins, such as BIM SAHB, ref Labelle et al JCI, 2012, 122 p. 2018-31) or selective activators of BAX or BAK (Gavathiotis et al. Nat Chem Biol, 2012, 8, 639-645).

In certain embodiments, combinations can include one or more additional therapeutic agents bind to and inhibit, or indirectly modulate, anti-apoptotic proteins and/or one or more additional therapeutic agents directly activate pro-apoptotic proteins, such as BIM SAHB, ref Labelle et al JCI, 2012, 122 p. 2018-31) or selective activators of BAX or BAK (Gavathiotis et al. Nat Chem Biol, 2012, 8, 639-645).

In some embodiments, the one or more additional therapeutic agents transcriptionally repress anti-apoptotic proteins (rather than directly bind and inhibit them); see, e.g., Wei et al Cancer Cell, 2012, 21, p 547-562.

In certain embodiments, the one or more additional therapeutic agents include: agents that induce apoptosis; polynucleotides (e.g., anti-sense, ribozymes, siRNA); polypeptides (e.g., enzymes and antibodies); biological mimetics (BH3 mimetics); alkaloids; alkylating agents; antitumor antibiotics; antimetabolites; hormones; platinum compounds; monoclonal or polyclonal antibodies (e.g., antibodies conjugated with anticancer drugs, toxins, defensins, etc.), toxins, radionuclides; biological response modifiers (e.g., interferons (e.g., IFN-α, etc.) and interleukins (e.g., IL-2, etc.), etc.); adoptive immunotherapy agents; hematopoietic growth factors; agents that induce tumor cell differentiation (e.g., all-trans-retinoic acid, etc.); gene therapy reagents (e.g., antisense therapy reagents and nucleotides); tumor vaccines; angiogenesis inhibitors; proteosome inhibitors: NF kappa β modulators; anti-CDK compounds; HDAC inhibitors; and the like.

In certain embodiments, at least one of the one or more additional therapeutic agents is a chemotherapeutic agent selected from an alkylating agent (e.g., carboplatin), an anti-metabolite (e.g., methotrexate), an anthracycline (e.g., doxorubicin), a plant alkaloid (e.g., vincristine), an antibody (e.g., rituxan), a steroid (e.g., dexamethasone), a targeted therapy (e.g., TRAIL, bortezamib), or another cytotoxic or cytostatic agent.

In certain embodiments, at least one of the one or more additional therapeutic agents is an agent that induces or stimulates apoptosis, including, but are not limited to, kinase inhibitors (e.g., Epidermal Growth Factor Receptor (EGFR) kinase inhibitor, Vascular Growth Factor Receptor (VGFR) kinase inhibitor, Fibroblast Growth Factor Receptor (FGFR) kinase inhibitor, Platelet-derived Growth Factor Receptor (PDGFR) kinase inhibitor, and Bcr-Abl kinase inhibitors such as GLEEVEC); antisense molecules; antibodies (e.g., HERCEPTIN, RITUXAN, ZEVALIN, and AVASTIN); anti-estrogens (e.g., raloxifene and tamoxifen); anti-androgens (e.g., flutamide, bicalutamide, finasteride, aminoglutethamide, ketoconazole, and corticosteroids); cyclooxygenase 2 (COX-2) inhibitors (e.g., celecoxib, meloxicam, NS-398, and non-steroidal anti-inflammatory drugs (NSAIDs)); anti-inflammatory drugs (e.g., butazolidin, DECADRON, DELTASONE, dexamethasone, dexamethasone intensol, DEXONE, HEXADROL, hydroxychloroquine, METICORTEN, ORADEXON, ORASONE, oxyphenbutazone, PEDIAPRED, phenylbutazone, PLAQUENIL, prednisolone, prednisone, PRELONE, and TANDEARIL); and cancer chemotherapeutic drugs (e.g., irinotecan (CAMPTOSAR), CPT-11, fludarabine (FLUDARA), dacarbazine (DTIC), dexamethasone, mitoxantrone, MYLOTARG, VP-16, cisplatin, carboplatin, oxaliplatin, 5-FU, doxorubicin, gemcitabine, bortezomib, gefitinib, bevacizumab, TAXOTERE or TAXOL); cellular signaling molecules; ceramides and cytokines; and staurosporine, and the like.

In certain embodiments, at least one of the one or more additional therapeutic agents is a chemotherapeutic agent (e.g., as defined above) and at least one of the one or more additional therapeutic agents is an agent that induces or stimulates apoptosis (e.g., as defined above), e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic proteins and/or one or more additional therapeutic agents directly activate pro-apoptotic proteins, such as BIM SAHB, ref Labelle et al JCI, 2012, 122 p. 2018-31) or selective activators of BAX or BAK (Gavathiotis et al. Nat Chem Biol, 2012, 8, 639-645); and/or one or more additional therapeutic agents that transcriptionally repress anti-apoptotic proteins (rather than directly bind and inhibit them); see, e.g., Wei et al Cancer Cell, 2012, 21, p 547-562.

[F] In some embodiments, the combinations further include one or more conventional non-toxic pharmaceutically-acceptable carriers, adjuvants or vehicles. In some cases, the pH of the formulation may be adjusted with pharmaceutically acceptable acids, bases or buffers to enhance the stability of the formulated compound or its delivery form. Thus, the combinations can be in the form of a pharmaceutical composition.

[G] In some embodiments, (i) the compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; (ii) the one or more additional therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic proteins; (iii) the one or more additional therapeutic agents (if present); and (iv) one or more conventional non-toxic pharmaceutically-acceptable carriers, adjuvants or vehicles (if present) form part of a single composition (e.g., a pharmaceutical composition) or single dosage form.

In other embodiments, at least one of (i), (ii), (iii), (iv) immediately above is/(are) contained or packaged separately from the other components of the combination (e.g., as part of a kit). In certain embodiments, when (i), (ii), and/or (iii) is separately contained or packaged, said separately contained or packaged therapeutic agent can be combined with one or more conventional non-toxic pharmaceutically-acceptable carriers, adjuvants or vehicles.

III

[A] In one aspect, methods for treating (e.g., controlling, relieving, ameliorating, alleviating, or slowing the progression of) or preventing (e.g., delaying the onset of or reducing the risk of developing) diseases, disorders, and conditions associated with deregulated apoptosis of cells (e.g., diseased or damaged cells; e.g., insufficient apoptosis of diseased or damaged cells; or the lack of apoptosis of diseased or damaged cells) in a subject in need thereof are featured. The methods include administering to the subject (e.g., an effective amount of) a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof or a combination that includes a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the agent.

[B] In another aspect, methods for treating (e.g., controlling, relieving, ameliorating, alleviating, or slowing the progression of) or preventing (e.g., delaying the onset of or reducing the risk of developing) diseases, disorders, and conditions associated with blockade(s) of cell death pathways (e.g., over-expression of anti-apoptotic proteins BCL-2 proteins) in a subject in need thereof are featured. The methods include administering to the subject (e.g., an effective amount of) a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof or a combination that includes a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the agent.

[C] In a further aspect, methods for treating (e.g., controlling, relieving, ameliorating, alleviating, or slowing the progression of) or preventing (e.g., delaying the onset of or reducing the risk of developing) a hyperproliferative disease in a subject in need thereof are featured. The methods include administering to the subject (e.g., an effective amount of) a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof or a combination that includes a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737)), or (where applicable) a pharmaceutically acceptable salt of the agent.

In an aspect, methods for treating (e.g., controlling, relieving, ameliorating, alleviating, or slowing the progression of) a hyperproliferative disease in a subject in need thereof are featured. The methods include administering to the subject (e.g., an effective amount of) a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof or a combination that includes a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the agent.

[D] In still another aspect, methods for treating (e.g., controlling, relieving, ameliorating, alleviating, or slowing the progression of) or preventing (e.g., delaying the onset of or reducing the risk of developing) cancer in a subject in need thereof are featured. The methods include administering to the subject (e.g., an effective amount of) a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof or a combination that includes a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the agent.

In an aspect, methods for treating (e.g., controlling, relieving, ameliorating, alleviating, or slowing the progression of) cancer in a subject in need thereof are featured. The methods include administering to the subject (e.g., an effective amount of) a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof or a combination that includes a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the agent.

[E] In yet another aspect, methods of modulating (e.g., increasing) apoptosis in vitro or in vivo are featured. Also featured are methods of modulating (e.g., decreasing) cell division in vitro or in vivo are featured.

In certain embodiments, the methods include contacting a sample (e.g., containing one or more cancer cells) with a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof or a combination that includes a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the agent.

In other embodiments, the methods include administering a a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof or combination that includes a compound of formula (I) and/or (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the agent to a subject (e.g., a subject in need thereof, e.g., a mammal, such as a human).

[F] In some embodiments, the methods described above and throughout this disclosure can include one or more of the following features.

[1] The cancer can include carcinomas (originating in the outer layer of cells of the skin and internal membranes, e.g., breasts, lungs, intestines, skin, prostate, etc.); sarcomas (arising from connective tissue such as bone, muscle, cartilage and blood vessels), and hematologic malignancies (e.g., lymphomas and leukemias, which arise in the blood or blood-forming organs such as the spleen, lymph nodes and bone marrow). Cancer cells can include, for example, tumor cells, neoplastic cells, malignant cells, metastatic cells, and hyperplastic cells.

Non-limiting examples of cancers include breast cancer, prostate cancer, lymphoma, skin cancer, pancreatic cancer, colon cancer, melanoma, malignant melanoma, ovarian cancer, brain cancer, primary brain carcinoma, head-neck cancer, glioma, glioblastoma, liver cancer, bladder cancer, non-small cell lung cancer, head or neck carcinoma, breast carcinoma, ovarian carcinoma, lung carcinoma, small-cell lung carcinoma, Wilms' tumor, cervical carcinoma, testicular carcinoma, bladder carcinoma, pancreatic carcinoma, stomach carcinoma, colon carcinoma, prostatic carcinoma, genitourinary carcinoma, thyroid carcinoma, esophageal carcinoma, myeloma, multiple myeloma, adrenal carcinoma, renal cell carcinoma, endometrial carcinoma, adrenal cortex carcinoma, malignant pancreatic insulinoma, malignant carcinoid carcinoma, choriocarcinoma, mycosis fungoides, malignant hypercalcemia, cervical hyperplasia, leukemia, acute lymphocytic leukemia, chronic lymphocytic leukemia, chronic granulocytic leukemia, acute granulocytic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, hairy cell leukemia, neuroblastoma, rhabdomyosarcoma, Kaposi's sarcoma, polycythemia vera, essential thrombocytosis, Hodgkin's disease, non-Hodgkin's lymphoma, soft-tissue sarcoma, osteogenic sarcoma, primary macroglobulinemia, and retinoblastoma.

In an embodiment, the disease or disorder is a hyperproliferative disorder, e.g., a lymphoma, leukemia, carcinoma (e.g. hepatic, breast, lung), multiple myeloma, or a sarcoma. In one embodiment, the leukemia is AML or ALL. In a related embodiment, the hyperproliferative disorder is a resistant hyperproliferative disorder; optionally, one that is resistant to a BCL-2 inhibitor. In another embodiment, the hyperproliferative disorder is a relapsed or refractory cancer.

[2] The subject can be a subject in need thereof (e.g., a subject identified as being in need of such treatment, such as a subject having, or at risk of having, one or more of the diseases or conditions described herein). Identifying a subject in need of such treatment can be in the judgment of a subject or a health care professional and can be subjective (e.g. opinion) or objective (e.g. measurable by a test or diagnostic method). In some embodiments, the subject can be a mammal. In certain embodiments, the subject can be a human.

[3] The one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents may be administered separately, as part of a multiple dose regimen, from the compound of formula (I) and/or (II) (e.g., sequentially, e.g., on different overlapping schedules with the administration of one or more compounds of formula (I) and/or (II) (including any subgenera or specific compounds thereof)). In other embodiments, the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents may be part of a single dosage form, mixed together with the compound of formula (I) and/or (II) in a single composition. In still another embodiment, the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents can be given as a separate dose that is administered at about the same time that one or more compounds of formula (I) and/or (II) are administered (e.g., simultaneously with the administration of one or more compounds of formula (I) and/or (II) (including any subgenera or specific compounds thereof)). Both the compound of formula (I) and/or (II) and the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents can be present at dosage levels of between about 1 to 100%, and more preferably between about 5 to 95% of the dosage normally administered in a monotherapy regimen.

[4] The methods described above and throughout this disclosure can include any one or more of the features described throughout any one or more of sections [II][A] through [II][G].

IV

In embodiments, an amount of a compound of formula (I) and/or (II) or salt thereof can be an effective amount. “An effective amount” refers to an amount of a compound that confers a therapeutic effect (e.g., treats, e.g., controls, relieves, ameliorates, alleviates, or slows the progression of; or prevents, e.g., delays the onset of or reduces the risk of developing, a disease, disorder, or condition or symptoms thereof) on the treated subject. The therapeutic effect may be objective (i.e., measurable by some test or marker) or subjective (i.e., subject gives an indication of or feels an effect). An effective amount of the compound described above may range from about 0.01 mg/kg to about 1000 mg/kg, (e.g., from about 0.1 mg/kg to about 100 mg/kg, from about 1 mg/kg to about 100 mg/kg). Effective doses will also vary depending on route of administration, as well as the possibility of co-usage with other agents.

The term “halo” or “halogen” refers to any radical of fluorine, chlorine, bromine or iodine.

In general, and unless otherwise indicated, substituent (radical) prefix names are derived from the parent hydride by either (i) replacing the “ane” in the parent hydride with the suffixes “yl,” “diyl,” “triyl,” “tetrayl,” etc.; or (ii) replacing the “e” in the parent hydride with the suffixes “yl,” “diyl,” “triyl,” “tetrayl,” etc. (Here the atom(s) with the free valence, when specified, is (are) given numbers as low as is consistent with any established numbering of the parent hydride). Accepted contracted names, e.g., adamantyl, naphthyl, anthryl, phenanthryl, furyl, pyridyl, isoquinolyl, quinolyl, and piperidyl, and trivial names, e.g., vinyl, allyl, phenyl, and thienyl are also used herein throughout. Conventional numbering/lettering systems are also adhered to for substituent numbering and the nomenclature of fused, bicyclic, tricyclic, and polycyclic rings.

The following definitions are used unless otherwise described. Specific and general values listed below for radicals, substituents, and ranges are for illustration only. They do not exclude other defined values or other values within defined ranges for the radicals and substituents. Unless otherwise indicated, alkyl, alkylene, alkoxy, alkenyl, and the like denote both straight and branched groups.

The term “alkyl” refers to a saturated hydrocarbon chain that may be a straight chain or branched chain, containing the indicated number of carbon atoms. For example, C₁-C₆ alkyl indicates that the group may have from 1 to 6 (inclusive) carbon atoms in it. Any atom can be optionally substituted, e.g., by one or more subsitutents. Examples of alkyl groups include, without limitation, methyl, ethyl, n-propyl, isopropyl, and tert-butyl.

The term “haloalkyl” refers to an alkyl group in which at least one hydrogen atom is replaced by halo. In some embodiments, more than one hydrogen atom (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) is replaced by halo. In these embodiments, the hydrogen atoms can each be replaced by the same halogen (e.g., fluoro) or the hydrogen atoms can be replaced by a combination of different halogens (e.g., fluoro and chloro). “Haloalkyl” also includes alkyl moieties in which all hydrogens have been replaced by halo (sometimes referred to herein as perhaloalkyl, e.g., perfluoroalkyl, such as trifluoromethyl). Any atom can be optionally substituted, e.g., by one or more substituents.

As referred to herein, the term “alkoxy” refers to a group of formula —O(alkyl). Alkoxy can be, for example, methoxy (—OCH₃), ethoxy, propoxy, isopropoxy, or butoxy.

The term “oxo” refers to doubly nond oxygen.

The term “alkenyl” refers to a straight or branched hydrocarbon chain containing the indicated number of carbon atoms and having one or more carbon-carbon double bonds. Any atom can be optionally substituted, e.g., by one or more substituents. Alkenyl groups can include, e.g., vinyl, allyl, 1-butenyl, and 2-hexenyl. One of the double bond carbons can optionally be the point of attachment of the alkenyl substituent.

The term “alkynyl” refers to a straight or branched hydrocarbon chain containing the indicated number of carbon atoms and having one or more carbon-carbon triple bonds. Alkynyl groups can be optionally substituted, e.g., by one or more substituents. Alkynyl groups can include groups such as ethynyl, propargyl, and 3-hexynyl. One of the triple bond carbons can optionally be the point of attachment of the alkynyl substituent.

The term “cycloalkyl” refers to a fully saturated monocyclic, bicyclic, tricyclic, or other polycyclic hydrocarbon group. Any atom can be optionally substituted, e.g., by one or more substituents. A ring carbon serves as the point of attachment of a cycloalkyl group to another moiety. Cycloalkyl moieties can include groups such as cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, adamantyl, and norbomyl (bicyclo[2.2.1]heptyl).

The term “aryl” refers to an aromatic monocyclic, bicyclic (2 fused rings), tricyclic (3 fused rings), or polycyclic (>3 fused rings) hydrocarbon ring system. One or more ring atoms can be optionally substituted by one or more substituents for example. Aryl moieties include groups such as phenyl and naphthyl.

The term “heteroaryl” refers to a stable 5- to 13-membered aromatic heterocycle having in the range of from 1 up to 4 heteroatoms from the group consisting of nitrogen, phosphorus, oxygen and sulfur, which ring or ring system can be linked via a carbon atom or a nitrogen atom, if such an atom is present. For purposes of this invention, the heteroaryl ring radical may be a monocyclic, bicyclic or tricyclic ring system. Examples of such heteroaryl radicals are: pyridyl, pyridyl N-oxide, pyrimidyl, pyridazinyl, pyrazinyl, thienyl, furyl, pyrrolyl, pyrazolyl, imidazolyl, thiazolyl, oxazolyl or isoxazolyl, indolicenyl, indolyl, benzo[b]thienyl, benzo[b]furyl, benzothiazolyl, benzothiadiazolyl, indazolyl, quinolyl, isoquinolyl, isoquinolyl, naphthyridinyl, quinazolinyl, oxadiazolyl, benzoxazolyl, tetrazoyl, triazolyl, thiadiazolyl, and benzimidazolyl.

The term “heterocycloalkyl” or “heterocyclyl” refers to a stable 3 to 13 membered saturated or partially unsaturated heterocycle having in the range from 1 up to 4 heteroatoms from the group consisting of nitrogen, phosphorus, oxygen and sulfur, which ring or ring system can be linked via a carbon atom or a nitrogen atom, if such an atom is present. For purposes of this invention, the heterocyclic ring radical may be a monocyclic, bicyclic or tricyclic ring system, which may include fused, bridged or spiro ring systems. Examples of such heterocyclyl radicals are: tetrahydropyranyl, aziridyl, azepanyl, tetrahydrofuryl, pyrrolidinyl, pyrrolinyl, piperidinyl, 1,2 dihydropyridinyl, 1,4 dihydropyridinyl, piperazinyl, morpholinyl, thiomorpholinyl, azepinyl, oxazolinyl, thiazolinyl and 1,4 diazepinyl.

The term “substituent” refers to a group “substituted” on groups such as an alkyl, haloalkyl, cycloakyl, heterocyclyl, aryl, or heteroaryl group at any atom of that group. In one aspect, the substituent(s) on a group are independently any one single or any combination of two or more of the permissible atoms or groups of atoms delineated for that substituent. In another aspect, a substituent may itself be substituted with any one of the above substituents.

Further, as used herein, the phrase “optionally substituted” means unsubstituted (e.g., substituted with hydrogen (H)) or substituted. As used herein, the term “substituted” means that a hydrogen atom is removed and replaced by a substituent. It is understood that substitution at a given atom is limited by valency.

Descriptors such as “C₆-C₁₀ aryl that is optionally substituted with from 1-4 independently selected R^(b) (and the like) is intended to include both an unsubstituted C₆-C₁₀ aryl group and a C₆-C₁₀ aryl group that is substituted with from 1-4 independently selected R^(b). The use of a substituent (radical) prefix name such as alkyl without the modifier “optionally substituted” or “substituted” is understood to mean that the particular substituent is unsubstituted. However, the use of “haloalkyl” without the modifier “optionally substituted” or “substituted” is still understood to mean an alkyl group, in which at least one hydrogen atom is replaced by halo.

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Methods and materials are described herein for use in the present invention; other, suitable methods and materials known in the art can also be used. The materials, methods, and examples are illustrative only and not intended to be limiting. All publications, patent applications, patents, sequences, database entries, and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the present specification, including definitions, will control.

Other features and advantages of the invention will be apparent from the following detailed description and figures, and from the claims.

DESCRIPTION OF DRAWINGS

FIGS. 1A and 1B are graphical representations of data related to the development of a Stapled Peptide-based High-Throughput Competitive Screening Assay for Identifying MCL-1-selective Small Molecules. High-throughput competitive fluorescence polarization (FP) binding assays were developed based on the direct binding interaction between FITC-MCL-1 SAHB_(A) and MCL-1ΔNΔC (EC₅₀, 14 nM) and FITC-BAD BH3 and BCL-X_(L)ΔC C (EC₅₀, 26 nM).

FIGS. 2A and 2B show Positive and Negative Controls for Screening Conditions. The initial screening conditions were validated for (A) MCL-1 screening using a positive control for complete displacement (BID SAHB_(A)) and a negative control for no displacement (BCL-2 SAHB_(A)), and for (B) BCL-X_(L) counterscreening using a positive control for complete displacement (BAD SAHB_(A)) and a negative control for no displacement (MCL-1 SAHB_(A)).

FIGS. 3A and 3B show Z-factor Determination for the MCL-1 Screen and BCL-X_(L) Counterscreen. (A) The MCL-1 screen yielded a Z-factor of 0.62, and (B) the BCL-X_(L) counterscreen yielded a Z-factor of 0.71.

FIG. 4 shows Identification of a Selective Inhibitor of Anti-apoptotic MCL-1. A high-throughput stapled peptide-based screen for small molecules that selectively target MCL-1ΔNΔC identified MIM1. The molecular structure of MIM1 is characterized by a thiazolyl core substituted with methyl, cyclohexylimino, and benzenetriol R groups.

FIG. 5 shows ¹H NMR of MIM1.

FIGS. 6A, 6B, and 6C show MIM1 binds MCL-1 selectively in an FP competition assay. (A) MCL-1 SAHB_(D) and MIM1 dose-responsively compete with FITC-MCL-1 SAHB_(A) for binding to MCL-1ΔNΔC, whereas the BCL-2/BCL-X_(L)-selective antagonist ABT-737 has no effect. (B) Similarly, MCL-1 SAHB_(D) and MIM1, but not ABT-737, effectively compete with FITC-BID BH3 peptide for binding to MCL-1ΔNΔC. (C) In contrast, ABT-737 dose-responsively competes with FITC-BID BH3 for binding to BCL-X_(L)ΔC, whereas MCL-1 SAHB_(D) and MIM1 show no BCL-X_(L)ΔC-binding activity. Data are mean±SEM for experiments performed in duplicate and repeated twice with independent preparations of recombinant protein with similar results.

FIG. 7 shows MIM1 Targets the Canonical BH3-Binding Pocket of MCL-1. Measured chemical shift changes of ¹⁵N-MCL-1ΔNΔC upon MIM1 titration up to a ratio of 2:1 MIM1:MCL-1 are plotted as a function of MCL-1ΔNΔC residue. Affected residues are represented as purple bars in the plot (calculated significance threshold >0.0197 p.p.m.). Residues with significant backbone amide chemical shift changes (purple) are concentrated in a subregion of the canonical BH3-binding pocket (green). Of note, MCL-1ΔNΔC residues M250, V253, F254, S255, D256, G257, G262, and R263 are unassigned.

FIG. 8 shows Molecular Docking of MIM1 on MCL-1ΔNΔC. The docked structure of MIM1 at the canonical BH3-binding pocket of MCL-1ΔNΔC predicts that (1) the cyclohexyl group makes complementary hydrophobic contacts with the region of the protein interface flanked by MCL-1 SAHB_(D) residues L213 and V216, (2) the thiazolyl core and its methyl substituent points directly into a deep crevice occupied by MCL-1 SAHB_(D) L213 in the stapled peptide/protein complex, and (3) the benzene-1,2,3-triol (or pyrogallol) moiety engages in hydrophilic contacts with D256 and R263, two charged MCL-1 residues implicated in complementary electrostatic interactions with R214 and D218 of MCL-1 SAHB_(D).

FIGS. 9A, 9B, 9C, and 9D show Selective Blockade of MCL-1-mediated Suppression of BAX activation by MIM1. (A) BH3-only protein tBID directly activates BAX-mediated liposomal release, which is effectively suppressed by treatment with anti-apoptotic MCL-1ΔNΔC and BCL-X_(L)ΔC. (B) MCL-1 SAHB_(D) selectively inhibits MCL-1ΔNΔC suppression of tBID-induced BAX activation. (C) ABT-737 selectively inhibits BCL-X_(L)ΔC suppression of tBID-induced BAX activation. (D) The activity profile of MIM1 in the liposomal release assay mirrors the MCL-1 selectivity of MCL-1 SAHB_(D). Liposomal assays were conducted in triplicate for each condition using two independent preparations of recombinant BAX with similar results.

FIG. 10 shows Western Blot Analysis of Genetically-defined p185⁺Arf^(−/−) Cells. Whereas the parental p185⁺Arf^(−/−) CML cells express both MCL-1 and BCL-X_(L), MCL-1- and BCL-X_(L)-rescued p185⁺Arf¹-Mcl-1^(−/−) cells demonstrate overexpression of MCL-1 or BCL-X_(L), respectively. The pro-apoptotic effectors BAX and BAK are expressed at similar levels in all three cell lines.

FIG. 11 shows MIM1 Selectively Impairs the Viability of MCL-1-dependent Leukemia Cells. MIM1 dose-responsively induces cell death of p185⁺Arf^(−/−)Mcl-1^(−/−) CML cells rescued by overexpression of MCL-1, but not BCL-X_(L), whereas ABT-737 has the opposite activity profile, as measured by CellTiter-Glo assay at 24 h. Data are mean±SEM for experiments performed in duplicate, normalized to vehicle control, and repeated at least twice with independent cell cultures.

FIG. 12 shows MIM1 Selectively Activates Caspase 3/7 in MCL-1-dependent Leukemia Cells. The selective cytotoxic effects of MIM1 and ABT-737 are accompanied by dose-responsive caspase 3/7 activation in the respective MCL-1 or BCL-X_(L)-rescued p185⁺Arf^(−/−)Mcl-1^(−/−) leukemia cell lines, as measured at 8 h post-treatment. Data are mean±SEM for experiments performed in duplicate, normalized to vehicle control, and repeated at least twice with independent cell cultures.

FIG. 13 shows Synergy of MIM1 and ABT-737 in the Context of Dual MCL-1 and BCL-X_(L) Expression. Combination treatment with MIM1 and ABT-737 induces synergistic killing of parental p185⁺Arf^(−/−) CML cells that express both MCL-1 and BCL-X_(L), as reflected by a leftward shift of the viability isotherm and the CalcuSyn dose effect curve, with calculated CI values of <1 at ED₅₀, ED₇₅, and ED₉₀. CI, combination index; ED, effective dose.

FIGS. 14A and 14B show MIM1/ABT-737 Synergy is Dependent on the Co-expression of MCL-1 and BCL-X_(L), and thus does not Manifest in the Context of Exclusive MCL-1 or BCL-X_(L) expression. (A) The addition of ABT-737 to MIM1 treatment of MCL-1-rescued p185⁺Arf^(−/−)Mcl-1^(−/−) CML cells had little to no additional cytotoxic effect, consistent with the relative inactivity of ABT-737 in the context of MCL-1-dependence. (B) Correspondingly, the addition of MIM1 to ABT-737 treatment of BCL-X_(L)-rescued p185⁺Arf^(−/−)Mcl-1^(−/−) CML cells provided no additional cytotoxic effect, consistent with the relative inactivity of MIM1 in the context of BCL-X_(L)-dependence. Data are mean±SEM for experiments performed in duplicate, normalized to vehicle control, and repeated at least twice with independent cell cultures.

FIGS. 15A, 15B, 15C, and 15D show Effect of MIM1 and ABT-737 on Mouse Embryonic Fibroblasts (MEFs). MIM1 and ABT-737 manifest little to no cytotoxicity (24 h) (A, B) or caspase 3/7 activation (8 h) (C, D) in wild-type or Bax^(−/−)Bak^(−/−) MEFs, suggesting the potential of a therapeutic window for MIM1. Data are mean±SEM for experiments performed in duplicate and repeated at least twice with independent cell cultures with similar results.

FIG. 16 shows exemplary formula (I) compounds.

FIG. 17 includes two graphs that show that compounds with enhanced binding activity to MCL-1 compared to MIM1 are more cytotoxic to MCL-1-dependent leukemia cells.

FIG. 18 includes two graphs that show that exemplary formula (I)/(II) compounds with variably enhanced MCL-1 binding activity exhibit a level of cytotoxicity in MCL-1-dependent leukemia cells that correlates with MCL-1 binding potency.

FIG. 19A and FIG. 19B are graphs that show potent targeting of the anti-apoptotic protein BFL-1/A1 by MIM1. FIG. 19A shows that FITC-BID BH3 directly binds to MCL-1ΔNΔC and BFL-1/A1ΔC with similar binding affinity. Thus, the complex between FITC-BID BH3 and BFL-1/A1ΔC was employed in a competitive FP assay to monitor the capacity of MIM1 to target BFL-1/A1ΔC. FIG. 19B shows that MIM1 manifests robust targeting of BFL1/A1ΔC, with effective competition in the nanomolar range.

FIGS. 20A and 20B shows exemplary formula (I)/(II) compounds that target both MCL-1 and BFL-1/A1 (20A) and that selectively target BFL-1/A1 (20B).

FIGS. 21A and 21B are graphs showing an example of an optimized compound with dual MCL-1 (20A) and BFL-1/A1 (20B) binding activity.

FIGS. 22A and 22B are graphs showing that select compounds of the formula (I)/(II) bind with high potency and selectivity to BFL-1/A1 (FIG. 22A), with little to no observed interaction with MCL-1 (FIG. 22B).

DETAILED DESCRIPTION

This disclosure features compounds and pharmaceutically acceptable salts thereof that inhibit MCL-1 and/or BFL-1/A1 and compositions containing the same. This disclosure also features combinations that include one or more of the MCL-1/BFL-1/A inhibitor compounds described herein, or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents (e.g., one or more chemotherapeutic agents (including but not limited to small molecule and/or anti-body based chemotherapy and/or radiation); e.g., one or more therapeutic agents that modulate apoptosis; e.g., one or more therapeutic agents that bind to and inhibit anti-apoptotic proteins or modulate them indirectly; e.g., one or more therapeutic agents that bind to and inhibit, or indirectly modulate, anti-apoptotic BCL-2, BCL-X_(L), BCL-w, MCL-1, and/or BFL-1/A1; e.g., one or more therapeutic agents that directly bind to and inhibit anti-apoptotic BCL-2/BCL-X_(L); e.g., agents such as ABT-199, ABT-263 and ABT-737; e.g., ABT-737), or (where applicable) a pharmaceutically acceptable salt of the one or more therapeutic agents (as well as compositions containing the same).

Also featured are methods of using any one or more of such MCL-1 and/or BFL-1/A1 inhibitor compounds, salts, combinations, and compositions, alone or in combination with other drugs e.g., for the treatment or prevention of diseases, disorders, and conditions associated with deregulated apoptosis of cells (e.g., diseased or damaged cells; e.g., insufficient apoptosis of diseased or damaged cells or reduced apoptosis of diseased or damaged cells) and/or other cancer treatment therapies (e.g., surgery, radiation).

The compounds, salts, combinations, and compositions described herein are therapeutically useful for treating (e.g., controlling, relieving, ameliorating, alleviating, or slowing the progression of) or preventing (e.g., delaying the onset of or reducing the risk of developing) diseases, disorders, and conditions associated with deregulated apoptosis of cells (e.g., diseased or damaged cells; e.g., insufficient apoptosis of diseased or damaged cells; or lack of apoptosis of diseased or damaged cells). Examples of such diseases, disorders, and conditions include (but are not limited to) those associated with blockade(s) of cell death pathways (e.g., over-expression of anti-apoptotic BCL-2 proteins; e.g., over-expression of anti-apoptotic BCL-2 proteins that fall outside of the inhibitory spectrum of a particular anti-apoptotic BCL-2 protein inhibitor, such as ABT-263 or ABT-737). Examples of such diseases, disorders, and conditions include hyperproliferative diseases, such as cancer.

While not wishing to be bound by theory, it is believed that the compounds, salts, combinations, and compositions described herein induce and increase apoptosis in target cells (e.g., pathogenic cells including, but not limited to, cancer cells), thereby suppressing tumor growth and/or proliferation. It is further believed that increasing apoptosis in such target cells reestablishes the normal apoptotic control that, during homeostasis, is associated with a regulated balance between pro- and anti-apoptotic protein functions.

Compounds

Formula (I) Compounds

In some embodiments, R²² is aryl (e.g., phenyl), which is optionally substituted with from 1-5 (e.g., 1-3) independently selected Z (e.g., hydroxyl). In certain embodiments, R²² is phenyl, which is optionally substituted with from 1-3 hydroxyl groups.

In some embodiments, R²³ is C₁-C₈ (e.g., C₁-C₄) alkyl; e.g., CH₃.

In some embodiments, R²⁴ is unsubstituted cycloalkyl or cycloalkyl (e.g., C₃-C₇) that is substituted with from 1-5 (e.g., 1-3) independently selected Z; e.g., unsubstituted cycloalkyl, e.g., cyclohexyl.

In some embodiments:

R²² is aryl (e.g., phenyl), which is optionally substituted with from 1-5 (e.g., 1-3) independently selected Z (e.g., hydroxyl). In certain embodiments, R²² is phenyl, which is optionally substituted with from 1-3 hydroxyl groups; and

R²³ is C₁-C₈ (e.g., C₁-C₄) alkyl; e.g., CH₃; and

R²⁴ is unsubstituted cycloalkyl or cycloalkyl (e.g., C₃-C₇) that is substituted with from 1-5 (e.g., 1-3) independently selected Z; e.g., unsubstituted cycloalkyl, e.g., cyclohexyl.

In certain embodiments, the compound is:

which is sometimes referred to herein as “MIM1.”

Formula (II) Compounds

Variable R²²

In some embodiments, R²² is C₆-C₁₀ (e.g., C₆) aryl, which is optionally substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a).

In some embodiments, R²² is C₆-C₁₀ (e.g., C₆) aryl, which is substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a).

In certain embodiments, each R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.

In certain embodiments, each R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

In certain embodiments, one, two, or three (e.g., three) of the independently selected R^(a) are hydroxyl.

In some embodiments, R²² is C₆-C₁₀ (e.g., C₆) aryl, which is optionally substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a), wherein three of the independently selected R^(a) are hydroxyl.

In some embodiments, R²² has formula (A):

wherein:

one, two, or three (e.g., three) of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ are each independently selected R^(a), and the others are hydrogen.

In certain embodiments, each R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.

In certain embodiments, each R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

In certain embodiments, each R^(a) is hydroxyl.

In certain embodiments, three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ are each independently selected R^(a), and the other two are hydrogen.

For example, R²²¹, R²²², and R²²³ can each be independently selected R^(a), and R²²⁴ and R²²⁵ can be hydrogen.

In embodiments, R²²¹, R²²², and R²²³ are each independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH. (e.g., e.g.,).

In embodiments, R²²¹, R²²², and R²²³ are each independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

In embodiments, R²²¹, R²²², and R²²³ are each independently selected from halo and hydroxyl.

In embodiments, each of R²²¹, R²²², and R²²³ is hydroxyl.

As another example, R²²¹, R²²³, and R²²⁴ are each independently selected R^(a), and R²²² and R²²⁵ are hydrogen.

In embodiments, R²²¹, R²²³, and R²²⁴ are each independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.

In embodiments, R²²¹, R²²³, and R²²⁴ are each independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

In embodiments, R²²¹, R²²³, and R²²⁴ are each independently selected from halo and hydroxyl.

In embodiments, each of R²²¹, R²²³, and R²²⁴ is hydroxyl.

In embodiments, two of R²²¹, R²²³, and R²²⁴ (e.g., R²²³ and R²²⁴) are hydroxyl, and the other (e.g., R²²¹) is halo.

As a further example, R²²², R²²³, and R²²⁴ are each independently selected Ra, and R²²¹ and R²²⁵ are hydrogen.

In embodiments, R²²², R²²³, and R²²⁴ are each independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.

In embodiments, R²²², R²²³, and R²²⁴ are each independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

In embodiments, R²²², R²²³, and R²²⁴ are each independently selected from halo and hydroxyl.

In embodiments, each of R²²², R²²³, and R²²⁴ is hydroxyl.

In certain embodiments, two of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²² and R²²³; R²²¹ and R²²²; or R²²¹ and R²²³) are each independently selected R^(a), and the other three are hydrogen.

In embodiments, each R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.

In embodiments, each R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

In embodiments, each R^(a) is hydroxyl.

In certain embodiments, one of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²³) is R^(a), and the other four are hydrogen.

In embodiments, R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.

In embodiments, R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

In embodiments, R^(a) is hydroxyl.

Variable R²³

In some embodiments, R²³ is:

(i) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(ii) phenyl that is optionally substituted with from independently selected 1-4 R^(c);

(iii) heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from 1-3 independently selected R^(c);

(iv) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d).

In some embodiments, R²³ is:

(i) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

In some embodiments, R²³ is C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²³ is C₃-C₆ cycloalkyl (e.g., cyclopropyl), which is optionally substituted with from 1-4 independently selected R^(d) (e.g., C₁-C₆ alkyl, C₁-C₃ alkyl).

In certain embodiments, R²³ is unsubstituted C₃-C₆ cycloalkyl (e.g., cyclopropyl).

In certain embodiments, R²³ is unsubstituted cyclopropyl.

In some embodiments, R²³ is C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₁-C₃ (e.g., C₁-C₂) alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₂-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₃-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₄-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is unsubstituted C₁-C₈ alkyl (e.g., unsubstituted C₂-C₈ alkyl, unsubstituted C₃-C₈ alkyl, unsubstituted branched C₃-C₈ alkyl, unsubstituted branched C₄-C₈ alkyl).

In certain embodiments, R²³ is CH₃.

In certain embodiments, R²³ is tert-butyl.

In some embodiments, R²³ is heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from 1-3 independently selected R^(c) (e.g., thienyl).

Variable R²⁴

In some embodiments, R²⁴ is:

(i) C₃-C₁₀ (e.g., C₃-C₈) cycloalkyl or C₃-C₁₀ (e.g., C₃-C₈) cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c);

(iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c);

(iv) unsubstituted C₁-C₈ alkyl or unsubstituted C₁-C₈ haloalkyl; or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d).

In some embodiments, R²⁴ is:

(i) C₃-C₁₀ (e.g., C₃-C₈) cycloalkyl or C₃-C₁₀ (e.g., C₃-C₈) cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c);

(iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c);

(iv) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d).

In some embodiments, R²⁴ is:

(i) C₃-C₁₀ (e.g., C₃-C₈) cycloalkyl or C₃-C₁₀ (e.g., C₃-C₈) cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(ii) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d).

In some embodiments, R²⁴ is:

(i) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c); or

(ii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c);

In some embodiments, R²⁴ is C₃-C₁₀ (e.g., C₃-C₈) cycloalkyl or C₃-C₁₀ (e.g., C₃-C₈) cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d).

In certain embodiments, R^(d) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a) and/or (b) below:

(a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; or

(b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl).

In certain embodiments, R^(d) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a) (e.g., C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl).

In certain embodiments, R^(d) at each occurrence is, independently, selected from any one the substituents delineated collectively in (a) (e.g., C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl); halo; and —OH.

In some embodiments, R²⁴ is C₃-C₁₀ (e.g., C₃-C₈) cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

In certain embodiments, R²⁴ is unsubstituted C₃-C₁₀ (e.g., C₃-C₈) cycloalkyl.

In certain embodiments, R²⁴ is C₃-C₈ (e.g., C₃-C₆, e.g., C₆) cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

In certain embodiments, R²⁴ is unsubstituted C₃-C₈ (e.g., C₃-C₆, e.g., C₆) cycloalkyl.

In certain embodiments, R²⁴ is cyclohexyl.

In some embodiments, R²⁴ is C₆-C₁₀ aryl (e.g., phenyl), which is optionally substituted with from 1-5 independently selected R^(c).

In certain embodiments, R²⁴ is unsubstituted C₆-C₁₀ aryl (e.g., phenyl).

In some embodiments, R²⁴ is unsubstituted C₁-C₈ alkyl or unsubstituted C₁-C₈ haloalkyl (e.g., unsubstituted C₁-C₈ alkyl; e.g., unsubstituted C₃-C₈ alkyl; e.g., unsubstituted branched C₃-C₈ alkyl).

In some embodiments, R²⁴ is heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d).

In certain embodiments, R²⁴ is piperidinyl.

Variables R²⁵, R²⁶, and R²⁷

In some embodiments, R²⁶ and R²⁷ together are a bond.

In some embodiments, R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl).

In some embodiments, R²⁵ is hydrogen.

In some embodiments, R²⁵ is a substituent other than hydrogen, such as C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); or —C(O)O(C₁-C₆ alkyl).

In certain embodiments, R²⁵ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is unsubstituted C₁-C₈ alkyl (e.g., C₁-C₃ alkyl, e.g., CH₃).

Non-limiting Combinations

[A] In some embodiments:

R²⁶ and R²⁷ together are a bond;

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl).

[B] In some embodiments:

R²³ is:

(i) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(ii) phenyl that is optionally substituted with from independently selected 1-4 R^(c);

(iii) heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from 1-3 independently selected R^(c);

(iv) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl).

[C] In some embodiments:

R²⁶ and R²⁷ together are a bond;

and

R²³ is:

(i) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(ii) phenyl that is optionally substituted with from independently selected 1-4 R^(c);

(iii) heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from 1-3 independently selected R^(c);

(iv) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl).

[D] In some embodiments:

R²² is C₆-C₁₀ (e.g., C₆) aryl, which is substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a) (e.g., hydroxyl);

and

R²³ is:

(i) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) branched C₃-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); or

(iii) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is:

(i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c);

(iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c);

(iv) unsubstituted C₁-C₈ alkyl or unsubstituted C₁-C₈ haloalkyl; or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d).

[E] In some embodiments:

R²² is C₆-C₁₀ (e.g., C₆) aryl, which is substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a) (e.g., hydroxyl);

and

R²³ is:

(i) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) branched C₃-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); or

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is:

(i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

(ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c);

(iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c);

(iv) unsubstituted C₁-C₈ alkyl or unsubstituted C₁-C₈ haloalkyl; or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d).

[F] In some embodiments:

R²² is C₆-C₁₀ (e.g., C₆) aryl, which is substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected Ra (e.g., hydroxyl);

and

R²³ is:

(i) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(ii) phenyl that is optionally substituted with from independently selected 1-4 R^(c);

(iii) heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from independently selected 1-3 R^(c); or

(iv) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is:

(i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(ii) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d).

[G] In some embodiments:

R²² is C₆-C₁₀ (e.g., C₆) aryl, which is substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a) (e.g., hydroxyl);

and

R²³ is:

(i) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(ii) phenyl that is optionally substituted with from independently selected 1-4 R^(c);

(iii) heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from independently selected 1-3 R^(c); or

(iv) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d);

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d).

[H] In some embodiments:

R²² is C₆-C₁₀ (e.g., C₆) aryl, which is substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a) (e.g., hydroxyl);

and

R²³ is C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d);

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are each independently selected R^(a), and the others are hydrogen.

In certain embodiments, each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.

In certain embodiments, each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

In certain embodiments, each of the three R^(a) is hydroxyl.

In some embodiments, R²⁵ is hydrogen.

In some embodiments, R²⁵ is a substituent other than hydrogen, such as C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is unsubstituted C₁-C₈ alkyl (e.g., C₁-C₃ alkyl, e.g., CH₃).

In some embodiments, R²³ is C₃-C₆ cycloalkyl (e.g., cyclopropyl), which is optionally substituted with from 1-4 independently selected R^(d) (e.g., C₁-C₆ alkyl, C₁-C₃ alkyl).

In some embodiments, R²⁴ is C₃-C₈ (e.g., C₃-C₆, e.g., C₆) cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

[I] In some embodiments:

R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are each independently selected R^(a), and the others are hydrogen (e.g., each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH; e.g., each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH; e.g., each of the three R^(a) is hydroxyl);

and

R²³ is C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl (e.g., C₃-C₆ cycloalkyl), each of which is optionally substituted with from 1-4 independently selected R^(d);

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl (e.g., C₃-C₁₀ cycloalkyl), each of which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²⁵ is hydrogen.

In some embodiments, R²⁵ is C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is unsubstituted C₁-C₈ alkyl (e.g., C₁-C₃ alkyl, e.g., CH₃).

In some embodiments, R²³ is C₃-C₆ cycloalkyl (e.g., cyclopropyl), which is optionally substituted with from 1-4 independently selected R^(d) (e.g., C₁-C₆ alkyl, C₁-C₃ alkyl).

In some embodiments, R²⁴ is C₃-C₈ (e.g., C₃-C₆, e.g., C₆) cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

[J] In some embodiments:

R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are hydroxyl, and the others are hydrogen;

and

R²³ is C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl (e.g., C₃-C₆ cycloalkyl), each of which is optionally substituted with from 1-4 independently selected R^(d);

and

R²⁵ is:

(i) hydrogen; or

(ii) C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl (e.g., C₃-C₁₀ cycloalkyl), each of which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²⁵ is hydrogen.

In some embodiments, R²⁵ is C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is unsubstituted C₁-C₈ alkyl (e.g., C₁-C₃ alkyl, e.g., CH₃).

In some embodiments, R²³ is C₃-C₆ cycloalkyl (e.g., cyclopropyl), which is optionally substituted with from 1-4 independently selected R^(d) (e.g., C₁-C₆ alkyl, C₁-C₃ alkyl).

In some embodiments, R²⁴ is C₃-C₈ (e.g., C₃-C₆, e.g., C₆) cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

[K] In some embodiments:

R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are hydroxyl, and the others are hydrogen;

and

R²³ is C₃-C₆ cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d);

and

R²⁵ is hydrogen; or C₁-C₃ alkyl (e.g., CH₃);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²⁵ is hydrogen.

In certain embodiments, R²⁵ is unsubstituted C₁-C₃ alkyl, e.g., CH₃.

In some embodiments, R²³ is cyclopropyl, which is optionally substituted with from 1-4 independently selected R^(d) (e.g., C₁-C₆ alkyl, C₁-C₃ alkyl).

In some embodiments, R²⁴ is cyclohexyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

[L] In some embodiments:

R²² is C₆-C₁₀ (e.g., C₆) aryl, which is substituted with from 1-5 (e.g., 1-3, e.g., 3) independently selected R^(a) (e.g., hydroxyl);

and

R²³ is C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b);

(iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or

(iv) —C(O)O(C₁-C₆ alkyl);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are each independently selected R^(a), and the others are hydrogen.

In certain embodiments, each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.

In certain embodiments, each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH.

In certain embodiments, each of the three R^(a) is hydroxyl.

In some embodiments, R²⁵ is hydrogen.

In some embodiments, R²⁵ is a substituent other than hydrogen, such as C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is unsubstituted C₁-C₈ alkyl (e.g., C₁-C₃ alkyl, e.g., CH₃).

In some embodiments, R²⁴ is C₃-C₈ (e.g., C₃-C₆, e.g., C₆) cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

In some embodiments, R²³ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₁-C₃ (e.g., C₁-C₂) alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₂-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₃-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₄-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is unsubstituted C₁-C₈ alkyl (e.g., unsubstituted C₂-C₈ alkyl, unsubstituted C₃-C₈ alkyl, unsubstituted branched C₃-C₈ alkyl, unsubstituted branched C₄-C₈ alkyl).

In certain embodiments, R²³ is CH₃.

In certain embodiments, R²³ is tert-butyl.

[M] In some embodiments:

R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are each independently selected R^(a), and the others are hydrogen (e.g., each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH; e.g., each of the three R^(a) is independently selected from halo, hydroxyl, C₁-C₆ alkoxy; —NHC(O)(C₁-C₆ alkyl); and C(O)OH; e.g., each of the three R^(a) is hydroxyl);

and

R²³ is C₁-C₈ alkyl or C₁-C₈ haloalkyl (e.g., C₁-C₈ alkyl), each of which is optionally substituted with from 1-2 independently selected R^(b);

and

R²⁵ is:

(i) hydrogen;

(ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); or

(iv) —C(O)O(C₁-C₆ alkyl);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl (e.g., C₃-C₁₀ cycloalkyl), each of which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²⁵ is hydrogen.

In some embodiments, R²⁵ is C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is unsubstituted C₁-C₈ alkyl (e.g., C₁-C₃ alkyl, e.g., CH₃).

In some embodiments, R²⁴ is C₃-C₈ (e.g., C₃-C₆, e.g., C₆) cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

In some embodiments, R²³ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₁-C₃ (e.g., C₁-C₂) alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₂-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₃-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₄-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is unsubstituted C₁-C₈ alkyl (e.g., unsubstituted C₂-C₈ alkyl, unsubstituted C₃-C₈ alkyl, unsubstituted branched C₃-C₈ alkyl, unsubstituted branched C₄-C₈ alkyl).

In certain embodiments, R²³ is CH₃.

In certain embodiments, R²³ is tert-butyl.

[N] In some embodiments:

R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are hydroxyl, and the others are hydrogen;

and

R²³ is C₁-C₈ alkyl or C₁-C₈ haloalkyl (e.g., C₁-C₈ alkyl), each of which is optionally substituted with from 1-2 independently selected R^(b);

and

R²⁵ is:

(i) hydrogen; or

(ii) C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b); or

(iv) —C(O)O(C₁-C₆ alkyl);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl (e.g., C₃-C₁₀ cycloalkyl), each of which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²⁵ is hydrogen.

In some embodiments, R²⁵ is C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²⁵ is unsubstituted C₁-C₈ alkyl (e.g., C₁-C₃ alkyl, e.g., CH₃).

In some embodiments, R²⁴ is C₃-C₈ (e.g., C₃-C₆, e.g., C₆) cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

In some embodiments, R²³ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₁-C₃ (e.g., C₁-C₂) alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₂-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₃-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₄-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is unsubstituted C₁-C₈ alkyl (e.g., unsubstituted C₂-C₈ alkyl, unsubstituted C₃-C₈ alkyl, unsubstituted branched C₃-C₈ alkyl, unsubstituted branched C₄-C₈ alkyl).

In certain embodiments, R²³ is CH₃.

In certain embodiments, R²³ is tert-butyl.

[O] In some embodiments:

R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are hydroxyl, and the others are hydrogen;

and

R²³ is C₁-C₈ alkyl (e.g., C₃-C₈ alkyl, branched C₃-C₈ alkyl, e.g., tert-butyl; or CH₃), which is optionally substituted with from 1-2 independently selected R^(b);

and

R²⁵ is hydrogen; C₁-C₃ alkyl (e.g., CH₃); or (—C(O)O(C₁-C₆ alkyl); (e.g., hydrogen; C₁-C₃ alkyl (e.g., CH₃));

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²⁵ is hydrogen.

In certain embodiments, R²⁵ is unsubstituted C₁-C₃ alkyl, e.g., CH₃.

In some embodiments, R²⁴ is cyclohexyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

In some embodiments, R²³ is C₁-C₃ (e.g., C₁-C₂) alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₂-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₃-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₃-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is straight chain C₄-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).

In certain embodiments, R²³ is branched C₄-C₈ alkyl (e.g., tert-butyl), which is optionally substituted with from 1-2 independently selected R^(b).

In some embodiments, R²³ is unsubstituted C₁-C₈ alkyl (e.g., unsubstituted C₂-C₈ alkyl, unsubstituted C₃-C₈ alkyl, unsubstituted branched C₃-C₈ alkyl, unsubstituted branched C₄-C₈ alkyl).

In certain embodiments, R²³ is CH₃.

In certain embodiments, R²³ is tert-butyl.

[P] In some embodiments:

R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are hydroxyl, and the others are hydrogen;

and

R²³ is:

(i) C₃-C₆ cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d); or

(ii) C₁-C₈ alkyl (e.g., C₃-C₈ alkyl, branched C₃-C₈ alkyl, e.g., tert-butyl; or CH₃), which is optionally substituted with from 1-2 independently selected R^(b);

and

R²⁵ is hydrogen; or C₁-C₃ alkyl (e.g., CH₃);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d) (e.g., piperidinyl).

In some embodiments, R²⁵ is hydrogen.

In certain embodiments, R²⁵ is unsubstituted C₁-C₃ alkyl, e.g., CH₃.

In some embodiments, R²³ is cyclopropyl, which is optionally substituted with from 1-4 independently selected R^(d) (e.g., C₁-C₆ alkyl, C₁-C₃ alkyl).

[Q] In some embodiments:

R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are hydroxyl, and the others are hydrogen;

and

R²³ is:

(i) C₃-C₆ cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d); or

(ii) C₁-C₈ alkyl (e.g., C₃-C₈ alkyl, branched C₃-C₈ alkyl, e.g., tert-butyl; or CH₃), which is optionally substituted with from 1-2 independently selected R^(b);

and

R²⁵ is hydrogen; or C₁-C₃ alkyl (e.g., CH₃);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R; (e.g., phenyl).

In some embodiments, R²⁵ is hydrogen.

In certain embodiments, R²⁵ is unsubstituted C₁-C₃ alkyl, e.g., CH₃.

In some embodiments, R²³ is cyclopropyl, which is optionally substituted with from 1-4 independently selected R^(d) (e.g., C₁-C₆ alkyl, C₁-C₃ alkyl).

[R] In some embodiments:

R²² has formula (A) as defined herein, in which three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ (e.g., R²²¹, R²²³, and R²²⁴; or R²²¹, R²²², and R²²³) are hydroxyl, and the others are hydrogen;

and

R²³ is heteroaryl containing from 5-6 ring atoms, wherein from 1-4 of the ring atoms is independently selected from N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heteroaryl is optionally substituted with from 1-3 independently selected R^(c) (e.g., thienyl).

and

R²⁵ is hydrogen; or C₁-C₃ alkyl (e.g., CH₃);

and

R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached);

and

R²⁴ is C₃-C₁₀ cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d).

In some embodiments, R²⁵ is hydrogen.

In certain embodiments, R²⁵ is unsubstituted C₁-C₃ alkyl, e.g., CH₃.

In some embodiments, R²³ is cyclopropyl, which is optionally substituted with from 1-4 independently selected R^(d) (e.g., C₁-C₆ alkyl, C₁-C₃ alkyl).

In some embodiments, R²⁴ is cyclohexyl, which is optionally substituted with from 1-4 independently selected R^(d) (as defined above or anywhere herein).

Exemplary compounds include those in Table A below; see also the compounds delineated in FIGS. 20A and 20B. In certain embodiments, the compound is 187-7.

TABLE A ID Structure MCL-1 (IC₅₀) BFL-1/A1 (IC₅₀) 187-7

123 nM 26 nM 183-87

151 nM 42 nM 183-44

540 nM 914 nM 187-44

587 nM 117 nM 183-89

780 nM 581 nM 187-19

891 nM 124 nM 178-83

910 nM 785 nM 187-79

937 nM 272 nM 183-82

1.0 uM 169 nM 183-88

1.16 uM 759 nM 187-22

1.41 uM 144 nM 183-8

1.5 uM 712 nM 187-20

1.78 uM 2.1 uM 183-70

1.97 uM 1.5 uM 178-82

2.1 uM 1.2 uM 183-22

2.4 uM 601 nM 187-5

2.7 uM 1.1 uM 183-51

2.9 uM 1.2 uM 183-19

3.1 uM 631 nM 183-21

4.3 uM 719 nM 187-27

4.3 uM 1.5 uM 187-23

4.36 uM 1.1 uM 183-81

4.5 uM 1.3 uM 187-39

7.3 uM 1.1 uM 183-85

7.6 uM — 178-97

9.5 uM 1.0 uM 183-76

11 uM 388 nM 183-91

11.8 uM 381 nM 183-38

12 uM 282 nM 183-84

13 uM 316 nM 187-82

13.3 uM 8.1 uM 183-63

— — 178-32

— — 178-21

— — 178-23

— — 187-10

— 9.1 uM 187-37

— 2.8 uM 178-31

— 187-50

— 735 nM 187-58

— 689 nM 187-60

— 718 nM 187-81

— 31 uM 187-50

— 735 nM 187-58

— 265 nM 187-60

— 718 nM 187-81

— 31 uM 187-82

— 8.1 uM 187-95

— 3.0 uM 187-112

— — 187-113

— — 187-114

— — 190-4

— 15 uM 190-18

1.7 uM 190-20

365 nM 183-36

— — 178-31

— — 183-20

— 264 nM 183-70

— 1.5 uM 183-75

— — 183-83

— — 183-95

— — 187-8

— 8.4 uM 178-72

16 uM 5.1 uM 183-24

16 uM 2.5 uM 183-65

17.7 uM 2.1 uM

Compound Forms and Salts

In some embodiments, the formula (I) and/or (II) compounds described herein may contain one or more asymmetric centers and thus occur as racemates and racemic mixtures, enantiomerically enriched mixtures, single enantiomers, individual diastereomers and diastereomeric mixtures (e.g., including (R)- and (S)-enantiomers, diastereomers, (D)-isomers, (L)-isomers, (+) (dextrorotatory) forms, (−) (levorotatory) forms, the racemic mixtures thereof, and other mixtures thereof). Additional asymmetric carbon atoms may be present in a substituent, such as an alkyl group. All such isomeric forms, as well as mixtures thereof, of these compounds are expressly included in the present invention. The compounds described herein may also or further contain linkages wherein bond rotation is restricted about that particular linkage, e.g. restriction resulting from the presence of a ring or double bond (e.g., carbon-carbon bonds, carbon-nitrogen bonds such as amide bonds). Accordingly, all cis/trans and E/Z isomers and rotational isomers are expressly included in the present invention. The compounds of this invention may also be represented in multiple tautomeric forms; in such instances, the invention expressly includes all tautomeric forms of the compounds described herein, even though only a single tautomeric form may be represented. All such isomeric forms of such compounds are expressly included in the present invention. Unless otherwise mentioned or indicated, the chemical designation of a compound encompasses the mixture of all possible stereochemically isomeric forms of that compound.

Optical isomers can be obtained in pure form by standard procedures known to those skilled in the art, and include, but are not limited to, diastereomeric salt formation, kinetic resolution, and asymmetric synthesis. See, for example, Jacques, et al., Enantiomers, Racemates and Resolutions (Wiley Interscience, New York, 1981); Wilen, S. H., et al., Tetrahedron 33:2725 (1977); Eliel, E. L. Stereochemistry of Carbon Compounds (McGraw-Hill, NY, 1962); Wilen, S. H. Tables of Resolving Agents and Optical Resolutions p. 268 (E. L. Eliel, Ed., Univ. of Notre Dame Press, Notre Dame, Ind. 1972), each of which is incorporated herein by reference in their entireties. It is also understood that this invention encompasses all possible regioisomers, and mixtures thereof, which can be obtained in pure form by standard separation procedures known to those skilled in the art, and include, but are not limited to, column chromatography, thin-layer chromatography, and high-performance liquid chromatography.

The combinations described herein can include formula (I) and/or (II) compounds that are in the form of a salt. A salt, for example, can be formed between an anion and a positively charged substituent (e.g., amino) on a compound described herein. Suitable anions include chloride, bromide, iodide, sulfate, nitrate, phosphate, citrate, methanesulfonate, trifluoroacetate, and acetate. Likewise, a salt can also be formed between a cation and a negatively charged substituent (e.g., carboxylate) on a compound described herein. Suitable cations include sodium ion, potassium ion, magnesium ion, calcium ion, and an ammonium cation such as tetramethylammonium ion.

Pharmaceutically acceptable salts of the formula (I) and/or (II) compounds include those derived from pharmaceutically acceptable inorganic and organic acids and bases. As used herein, the term “pharmaceutically acceptable salt” refers to a salt formed by the addition of a pharmaceutically acceptable acid or base to a compound disclosed herein. As used herein, the phrase “pharmaceutically acceptable” refers to a substance that is acceptable for use in pharmaceutical applications from a toxicological perspective and does not adversely interact with the active ingredient.

Examples of suitable acid salts include acetate, adipate, alginate, aspartate, benzoate, benzenesulfonate, bisulfate, butyrate, citrate, camphorate, camphorsulfonate, digluconate, dodecylsulfate, ethanesulfonate, formate, fumarate, glucoheptanoate, glycolate, hemisulfate, heptanoate, hexanoate, hydrochloride, hydrobromide, hydroiodide, 2-hydroxyethanesulfonate, lactate, maleate, malonate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, palmoate, pectinate, persulfate, 3-phenylpropionate, phosphate, picrate, pivalate, propionate, salicylate, succinate, sulfate, tartrate, thiocyanate, tosylate and undecanoate. Other acids, such as oxalic, while not in themselves pharmaceutically acceptable, may be employed in the preparation of salts useful as intermediates in obtaining the compounds of the invention and their pharmaceutically acceptable acid addition salts. Salts derived from appropriate bases include alkali metal (e.g., sodium), alkaline earth metal (e.g., magnesium), ammonium and N-(alkyl)₄ ⁺ salts. This invention also envisions the quaternization of any basic nitrogen-containing groups of the compounds disclosed herein. Water or oil-soluble or dispersible products may be obtained by such quaternization. Salt forms of the compounds of any of the formulae herein can be amino acid salts of carboxy groups (e.g. L-arginine, -lysine, -histidine salts).

Lists of suitable salts are found in Remington's Pharmaceutical Sciences, 17th ed., Mack Publishing Company, Easton, Pa., 1985, p. 1418; Journal of Pharmaceutical Science, 66, 2 (1977); “Pharmaceutical Salts: Properties, Selection, and Use A Handbook; Wermuth, C. G. and Stahl, P. H. (eds.) Verlag Helvetica Chimica Acta, Zurich, 2002 [ISBN 3-906390-26-8]; and Berge et al. (1977) “Pharmaceutical Salts”, J. Pharm. Sci. 66:1-19; each of which is incorporated herein by reference in its entirety.

The neutral forms of the compounds may be regenerated by contacting the salt with a base or acid and isolating the parent compound in the conventional manner. The parent form of the compound differs from the various salt forms in certain physical properties, such as solubility in polar solvents, but otherwise the salts are equivalent to the parent form of the compound for the purposes of the invention.

In addition to salt forms, the invention includes formula (I) and/or (II) compounds which are in a prodrug form. Prodrugs of the compounds described herein are those compounds that undergo chemical changes under physiological conditions to provide the compounds of the invention. Additionally, prodrugs can be converted to the compounds of the invention by chemical or biochemical methods in an ex vivo environment. For example, prodrugs can be slowly converted to the compounds of the invention when placed in a transdermal patch reservoir with a suitable enzyme or chemical reagent. Prodrugs are often useful because, in some situations, they may be easier to administer than the parent drug. They may, for instance, be more bioavailable by oral administration than the parent drug. The prodrug may also have improved solubility in pharmacological compositions over the parent drug. A wide variety of prodrug derivatives are known in the art, such as those that rely on hydrolytic cleavage or oxidative activation of the prodrug.

The invention also includes various hydrate and solvate forms of the formula (I) compounds (and salts thereof) described herein.

The formula (I) and/or (II) compounds may also contain unnatural proportions of atomic isotopes at one or more of the atoms that constitute such compounds. For example, the compounds may be radiolabeled with radioactive isotopes, such as for example tritium (³H), iodine-125 (¹²⁵I) or carbon-14 (¹⁴C). All isotopic variations of the compounds of the invention, whether radioactive or not, are intended to be encompassed within the scope of the invention.

Synthesis of Compounds

Methods of obtaining a formula (I) and/or (II) compound or other therapeutic agents described herein include purchasing, synthesizing or otherwise acquiring the compound.

In some embodiments, the formula (I) and/or (II) compounds can be prepared using the methods outlined in the schemes below (see also the Examples section).

Synthesizing the compounds described herein is within the skill of the organic chemistry art. The compounds described herein can be conveniently prepared in accordance with the procedures outlined herein, from commercially available starting materials, compounds known in the literature, or readily prepared intermediates, by employing standard synthetic methods and procedures known to those skilled in the art. Standard synthetic methods and procedures for the preparation of organic molecules and functional group transformations and manipulations can be readily obtained from the relevant scientific literature or from standard textbooks in the field. It will be appreciated that where typical or preferred process conditions (i.e., reaction temperatures, times, mole ratios of reactants, solvents, pressures, etc.) are given, other process conditions can also be used unless otherwise stated. Optimum reaction conditions may vary with the particular reactants or solvents used, but such conditions can be determined by one skilled in the art by routine optimization procedures. Those skilled in the art of organic synthesis will recognize that the nature and order of the synthetic steps presented may be varied for the purpose of optimizing the formation of the compounds described herein.

Synthetic chemistry transformations (including protecting group methodologies) useful in synthesizing the compounds described herein are known in the art and include, for example, those such as described in R. C. Larock, Comprehensive Organic Transformations, 2d.ed., Wiley-VCH Publishers (1999); P. G. M. Wuts and T. W. Greene, Protective Groups in Organic Synthesis, 4th Ed., John Wiley and Sons (2007); L. Fieser and M. Fieser, Fieser and Fieser's Reagents for Organic Synthesis, John Wiley and Sons (1994); and L. Paquette, ed., Encyclopedia ofReagents for Organic Synthesis, John Wiley and Sons (1995), and subsequent editions thereof.

The processes described herein can be monitored according to any suitable method known in the art. For example, product formation can be monitored by spectroscopic means, such as nuclear magnetic resonance spectroscopy (e.g., ¹H or ¹³C), infrared spectroscopy (FT-IR), spectrophotometry (e.g., UV-visible), or mass spectrometry (MS), or by chromatography such as high performance liquid chromatograpy (HPLC) or thin layer chromatography (TLC).

Preparation of compounds can involve the protection and deprotection of various chemical groups. The need for protection and deprotection, and the selection of appropriate protecting groups can be readily determined by one skilled in the art. The chemistry of protecting groups can be found, for example, in Greene, et al., Protective Groups in Organic Synthesis, 2d. Ed., Wiley & Sons, 1991, which is incorporated herein by reference in its entirety.

The reactions of the processes described herein can be carried out in suitable solvents which can be readily selected by one of skill in the art of organic synthesis. Suitable solvents can be substantially nonreactive with the starting materials (reactants), the intermediates, or products at the temperatures at which the reactions are carried out, i.e., temperatures which can range from the solvent's freezing temperature to the solvent's boiling temperature. A given reaction can be carried out in one solvent or a mixture of solvents. Depending on the particular reaction step, suitable solvents for a particular reaction step can be selected.

Pharmaceutical Compositions

The term “pharmaceutically acceptable carrier” refers to a carrier or adjuvant that may be administered to a subject (e.g., a patient), together with a compound of this invention, and which does not destroy the pharmacological activity thereof and is nontoxic when administered in doses sufficient to deliver a therapeutic amount of the combinations described herein.

Pharmaceutically acceptable carriers, adjuvants and vehicles that may be used in the combinations of the invention include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, self-emulsifying drug delivery systems (SEDDS) such as d-α-tocopherol polyethyleneglycol 1000 succinate, surfactants used in pharmaceutical dosage forms such as Tweens or other similar polymeric delivery matrices, serum proteins, such as human serum albumin, buffer substances such as phosphates, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts, or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol, sodium carboxymethylcellulose, polyacrylates, waxes, polyethylene-polyoxypropylene-block polymers, polyethylene glycol and wool fat. Cyclodextrins such as α-, β-, and γ-cyclodextrin, or chemically modified derivatives such as hydroxyalkylcyclodextrins, including 2- and 3-hydroxypropyl-β-cyclodextrins, or other solubilized derivatives may also be advantageously used to enhance delivery of the formula (I) compounds and therapeutic agent(s) that are present in the combinations described herein.

The compositions for administration can take the form of bulk liquid solutions or suspensions, or bulk powders. More commonly, however, the compositions are presented in unit dosage forms to facilitate accurate dosing. The term “unit dosage forms” refers to physically discrete units suitable as unitary dosages for human subjects and other mammals, each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect, in association with a suitable pharmaceutical excipient. Typical unit dosage forms include prefilled, premeasured ampules or syringes of the liquid compositions or pills, tablets, capsules, losenges or the like in the case of solid compositions. In such compositions, the compound is usually a minor component (from about 0.1 to about 50% by weight or preferably from about 1 to about 40% by weight) with the remainder being various vehicles or carriers and processing aids helpful for forming the desired dosing form.

The amount administered depends on the formulation, route of administration, etc. and is generally empirically determined in routine trials, and variations will necessarily occur depending on the target, the host, and the route of administration, etc. Generally, the quantity of the formula (I) and/or (II) compounds and therapeutic agent(s) that are present in the combinations described herein may be varied or adjusted from about 1, 3, 10 or 30 to about 30, 100, 300 or 1000 mg per in a unit dose of preparation, according to the particular application. In a particular embodiment, unit dosage forms are packaged in a multipack adapted for sequential use, such as blisterpack, comprising sheets of at least 6, 9 or 12 unit dosage forms. The actual dosage employed may be varied depending upon the requirements of the patient and the severity of the condition being treated. Determination of the proper dosage for a particular situation is within the skill of the art. Generally, treatment is initiated with smaller dosages which are less than the optimum dose of the formula (I) compounds and therapeutic agent(s) that are present in the combinations. Thereafter, the dosage is increased by small amounts until the optimum effect under the circumstances is reached. For convenience, the total daily dosage may be divided and administered in portions during the day if desired.

Use and Administration

The combinations described herein are therapeutically useful for treating (e.g., controlling, relieving, ameliorating, alleviating, or slowing the progression of) or preventing (e.g., delaying the onset of or reducing the risk of developing) diseases, disorders, and conditions associated with deregulated apoptosis of cells (e.g., diseased or damaged cells; e.g., insufficient apoptosis of diseased or damaged cells; or lack of apoptosis of diseased or damaged cells). Examples of such diseases, disorders, and conditions include (but are not limited to) those associated with blockade(s) of cell death pathways (e.g., over-expression of anti-apoptotic BCL-2 proteins; e.g., over-expression of anti-apoptotic BCL-2 proteins that fall outside of the inhibitory spectrum of a particular anti-apoptotic BCL-2 protein inhibitor, such as ABT-263 or ABT-737). Examples of such diseases, disorders, and conditions include hyperproliferative diseases, such as cancer.

As used herein the term “hyperproliferative disorder” refers to a disorder associated with an irregular or an abnormally high rate of cell division (which results in a rapid proliferation of the cells) or a blockade in the natural cell death pathway resulting in the accumulation of cells, or a combination thereof. Hyperproliferative disorders include but are not limited, e.g., solid and liquid tumors, such as cancers of the breast, respiratory tract, brain, reproductive organs, digestive tract, urinary tract, eye, liver, skin, head and neck, thyroid, parathyroid and their distant metastases, lymphomas, sarcomas, and leukemias.

Examples of breast cancer include, but are not limited to invasive ductal carcinoma, invasive lobular carcinoma, ductal carcinoma in situ, and lobular carcinoma in situ.

Examples of cancers of the respiratory tract include, but are not limited to small-cell and non-small-cell lung carcinoma, as well as bronchial adenoma and pleuropulmonary blastoma.

Examples of brain cancers include, but are not limited to brain stem and hypophtalmic glioma, cerebellar and cerebral astrocytoma, medulloblastoma, ependymoma, as well as neuroectodermal and pineal tumor.

Tumors of the male reproductive organs include, but are not limited to prostate and testicular cancer. Tumors of the female reproductive organs include, but are not limited to endometrial, cervical, ovarian, vaginal, and vulvar cancer, as well as sarcoma of the uterus.

Tumors of the digestive tract include, but are not limited to anal, colon, colorectal, esophageal, gallbladder, gastric, pancreatic, rectal, small-intestine, and salivary gland cancers.

Tumors of the urinary tract include, but are not limited to bladder, penile, kidney, renal pelvis, ureter, urethral and human papillary renal cancers.

Eye cancers include, but are not limited to intraocular melanoma and retinoblastoma.

Examples of liver cancers include, but are not limited to hepatocellular carcinoma (liver cell carcinomas with or without fibrolamellar variant), cholangiocarcinoma (intrahepatic bile duct carcinoma), and mixed hepatocellular cholangiocarcinoma.

Skin cancers include, but are not limited to squamous cell carcinoma, Kaposi's sarcoma, malignant melanoma, Merkel cell skin cancer, and non-melanoma skin cancer.

Head-and-neck cancers include, but are not limited to laryngeal, hypopharyngeal, nasopharyngeal, oropharyngeal cancer, lip and oral cavity cancer and squamous cell. Lymphomas include, but are not limited to AIDS-related lymphoma, non-Hodgkin's lymphoma, cutaneous T-cell lymphoma, Burkitt lymphoma, Hodgkin's disease, and lymphoma of the central nervous system.

Sarcomas include, but are not limited to sarcoma of the soft tissue, osteosarcoma, malignant fibrous histiocytoma, lymphosarcoma, and rhabdomyosarcoma.

Leukemias include, but are not limited to acute myeloid leukemia, acute lymphoblastic leukemia, chronic lymphocytic leukemia, chronic myelogenous leukemia, and hairy cell leukemia.

The one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents may be administered separately, as part of a multiple dose regimen, from the compound of formula (I) (e.g., sequentially, e.g., on different overlapping schedules with the administration of one or more compounds of formula (I) (including any subgenera or specific compounds thereof)). In other embodiments, the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents may be part of a single dosage form, mixed together with the compound of formula (I) in a single composition. In still another embodiment, the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents can be given as a separate dose that is administered at about the same time that one or more compounds of formula (I) are administered (e.g., simultaneously with the administration of one or more compounds of formula (I) (including any subgenera or specific compounds thereof)). Both the compound of formula (I) and the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents can be present at dosage levels of between about 1 to 100%, and more preferably between about 5 to 95% of the dosage normally administered in a monotherapy regimen.

The combinations described herein can, for example, be administered orally, parenterally (e.g., subcutaneously, intracutaneously, intravenously, intramuscularly, intraarticularly, intraarterially, intrasynovially, intrastemally, intrathecally, intralesionally and by intracranial injection or infusion techniques), by inhalation spray, topically, rectally, nasally, buccally, vaginally, via an implanted reservoir, by injection, subdermally, intraperitoneally, transmucosally, or in an ophthalmic preparation (or any combination thereof if, for example, the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents may be administered separately, as part of a multiple dose regimen, from the compound of formula (I)), with a dosage ranging from about 0.01 mg/kg to about 1000 mg/kg, (e.g., from about 0.01 to about 100 mg/kg, from about 0.1 to about 100 mg/kg, from about 1 to about 100 mg/kg, from about 1 to about 10 mg/kg) every 4 to 120 hours, or according to the requirements of the particular drug. The interrelationship of dosages for animals and humans (based on milligrams per meter squared of body surface) is described by Freireich et al., Cancer Chemother. Rep. 50, 219 (1966). Body surface area may be approximately determined from height and weight of the patient. See, e.g., Scientific Tables, Geigy Pharmaceuticals, Ardsley, N.Y., 537 (1970). In certain embodiments, the combinations are administered by oral administration or administration by injection. The methods herein contemplate administration of an effective amount of the compound of formula (I) and the one or more additional therapeutic agents that bind to and inhibit anti-apoptotic proteins and any additional therapeutic agents to achieve the desired or stated effect. In certain embodiments, the combinations of this invention will be administered from about 1 to about 6 times per day or alternatively, as a continuous infusion. Such administration can be used as a chronic or acute therapy.

Lower or higher doses than those recited above may be required. Specific dosage and treatment regimens for any particular patient will depend upon a variety of factors, including the activity of the specific compound employed, the age, body weight, general health status, sex, diet, time of administration, rate of excretion, drug combination, the severity and course of the disease, condition or symptoms, the patient's disposition to the disease, condition or symptoms, and the judgment of the treating physician.

Upon improvement of a patient's condition, a maintenance dose of a combination of this invention may be administered, if necessary. Subsequently, the dosage or frequency of administration, or both, may be reduced, as a function of the symptoms, to a level at which the improved condition is retained when the symptoms have been alleviated to the desired level. Patients may, however, require intermittent treatment on a long-term basis upon any recurrence of disease symptoms.

The combinations of this invention may contain any conventional non-toxic pharmaceutically-acceptable carriers, adjuvants or vehicles. In some cases, the pH of the formulation may be adjusted with pharmaceutically acceptable acids, bases or buffers to enhance the stability of the formulated compound or its delivery form.

The combinations may be in the form of a sterile injectable preparation, for example, as a sterile injectable aqueous or oleaginous suspension. This suspension may be formulated according to techniques known in the art using suitable dispersing or wetting agents (such as, for example, Tween 80) and suspending agents. The sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that may be employed are mannitol, water, Ringer's solution and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium. For this purpose, any bland fixed oil may be employed including synthetic mono- or diglycerides. Fatty acids, such as oleic acid and its glyceride derivatives are useful in the preparation of injectables, as are natural pharmaceutically-acceptable oils, such as olive oil or castor oil, especially in their polyoxyethylated versions. These oil solutions or suspensions may also contain a long-chain alcohol diluent or dispersant, or carboxymethyl cellulose or similar dispersing agents which are commonly used in the formulation of pharmaceutically acceptable dosage forms such as emulsions and or suspensions. Other commonly used surfactants such as Tweens or Spans and/or other similar emulsifying agents or bioavailability enhancers which are commonly used in the manufacture of pharmaceutically acceptable solid, liquid, or other dosage forms may also be used for the purposes of formulation.

The combinations of this invention may be orally administered in any orally acceptable dosage form including, but not limited to, capsules, tablets, emulsions and aqueous suspensions, dispersions and solutions. In the case of tablets for oral use, carriers which are commonly used include lactose and corn starch. Lubricating agents, such as magnesium stearate, are also typically added. For oral administration in a capsule form, useful diluents include lactose and dried corn starch. When aqueous suspensions and/or emulsions are administered orally, the active ingredient may be suspended or dissolved in an oily phase is combined with emulsifying and/or suspending agents. If desired, certain sweetening and/or flavoring and/or coloring agents may be added.

The combinations of this invention may also be administered in the form of suppositories for rectal administration. These compositions can be prepared by mixing a compound of this invention with a suitable non-irritating excipient which is solid at room temperature but liquid at the rectal temperature and therefore will melt in the rectum to release the active components. Such materials include, but are not limited to, cocoa butter, beeswax and polyethylene glycols.

Topical administration of the combinations of this invention is useful when the desired treatment involves areas or organs readily accessible by topical application. For application topically to the skin, the composition should be formulated with a suitable ointment containing the active components suspended or dissolved in a carrier. Carriers for topical administration of the compounds of this invention include, but are not limited to, mineral oil, liquid petroleum, white petroleum, propylene glycol, polyoxyethylene polyoxypropylene compound, emulsifying wax and water. Alternatively, the composition can be formulated with a suitable lotion or cream containing the active compound suspended or dissolved in a carrier with suitable emulsifying agents. Suitable carriers include, but are not limited to, mineral oil, sorbitan monostearate, polysorbate 60, cetyl esters wax, cetearyl alcohol, 2-octyldodecanol, benzyl alcohol and water. The compositions of this invention may also be topically applied to the lower intestinal tract by rectal suppository formulation or in a suitable enema formulation.

In some embodiments, topical administration of the combinations described herein may be presented in the form of an aerosol, a semi-solid pharmaceutical composition, a powder, or a solution. By the term “a semi-solid composition” is meant an ointment, cream, salve, jelly, or other pharmaceutical composition of substantially similar consistency suitable for application to the skin. Examples of semi-solid compositions are given in Chapter 17 of The Theory and Practice of Industrial Pharmacy, Lachman, Lieberman and Kanig, published by Lea and Febiger (1970) and in Remington's Pharmaceutical Sciences, 21st Edition (2005) published by Mack Publishing Company, which is incorporated herein by reference in its entirety.

Topically-transdermal patches are also included in this invention. Also within the invention is a patch to deliver active chemotherapeutic combinations herein. A patch includes a material layer (e.g., polymeric, cloth, gauze, bandage) and the compound of the formulae herein as delineated herein. One side of the material layer can have a protective layer adhered to it to resist passage of the compounds or compositions. The patch can additionally include an adhesive to hold the patch in place on a subject. An adhesive is a composition, including those of either natural or synthetic origin, that when contacted with the skin of a subject, temporarily adheres to the skin. It can be water resistant. The adhesive can be placed on the patch to hold it in contact with the skin of the subject for an extended period of time. The adhesive can be made of a tackiness, or adhesive strength, such that it holds the device in place subject to incidental contact, however, upon an affirmative act (e.g., ripping, peeling, or other intentional removal) the adhesive gives way to the external pressure placed on the device or the adhesive itself, and allows for breaking of the adhesion contact. The adhesive can be pressure sensitive, that is, it can allow for positioning of the adhesive (and the device to be adhered to the skin) against the skin by the application of pressure (e.g., pushing, rubbing,) on the adhesive or device.

The combinations of this invention may be administered by nasal aerosol or inhalation. Such compositions are prepared according to techniques well-known in the art of pharmaceutical formulation and may be prepared as solutions in saline, employing benzyl alcohol or other suitable preservatives, absorption promoters to enhance bioavailability, fluorocarbons, and/or other solubilizing or dispersing agents known in the art.

A combination can be administered using any of the routes of administration described herein. In some embodiments, a combination can be administered using an implantable device. Implantable devices and related technology are known in the art and are useful as delivery systems where a continuous, or timed-release delivery of compounds or compositions delineated herein is desired. Additionally, the implantable device delivery system is useful for targeting specific points of compound or composition delivery (e.g., localized sites, organs). Negrin et al., Biomaterials, 22(6):563 (2001). Timed-release technology involving alternate delivery methods can also be used in this invention. For example, timed-release formulations based on polymer technologies, sustained-release techniques and encapsulation techniques (e.g., polymeric, liposomal) can also be used for delivery of the compounds and compositions delineated herein.

EXAMPLES

The invention will be further described in the following examples. It should be understood that these examples are for illustrative purposes only and are not to be construed as limiting this invention in any manner.

Example 1 From Selective Stapled Peptide to Selective Small Molecule

MCL-1 SAHBs are hydrocarbon-stapled MCL-1 BH3 helices that were previously shown using chemical, structural, and biological methods to selectively target MCL-1 and sensitize cancer cells to caspase-dependent apoptosis³⁴. Here, we deployed MCL-1 SAHB_(A) as a high fidelity screening tool to determine if its potency and specificity-of-action could be harnessed for small molecule discovery. A high-throughput competitive fluorescence polarization (FP) screening assay (Z-factor, 0.62) was developed based on the direct binding interaction between FITC-MCL-1 SAHB_(A) and MCL-1ΔNΔC (EC₅₀, 14 nM) (FIGS. 1A, 2A, and 3A). A compilation of 71,296 small molecules was screened for the capacity to displace FITC-MCL-1 SAHB_(A) from recombinant MCL-1ΔNΔC (aa 172-327) (FIG. 4). To enrich for MCL-1-selective molecules by detecting binding activity for the BCL-X_(L) subclass of anti-apoptotic proteins, the library was also counterscreened using a competitive FP assay (Z-factor, 0.71) developed based on the direct and selective interaction between FITC-BAD BH3 and BCL-X_(L)ΔC (EC₅₀, 26 nM) (FIGS. 1B, 2B, and 3B). Small molecules with an apparent preference for MCL-1ΔNΔC (208 compounds, 0.3% hit rate), as defined both by >50% displacement of the FITC-MCL-1 SAHB_(A)/MCL-1ΔNΔC interaction and a >45% difference in peptide displacement from MCL-1ΔNΔC vs. BCL-X_(L)ΔC, were advanced to increasingly stringent confirmatory in vitro binding assays including: (1) repeat single-dose testing of 208 molecules in the differential competitive FP screen; (2) alternative single-dose selectivity screen for 130 confirmed MCL-1-directed antagonists comparing relative displacement of FITC-BID BH3, a dual binder,³⁵ from MCL-1 ΔNΔC vs. BCL-X_(L)ΔC; and then (3) dose-responsive competitive binding of the 64 most selective molecules against the FITC-MCL-1 SAHB_(A)/MCL-1 ΔNΔC complex (FIG. 4). Of the 64 compounds that competed with FITC-MCL-1 SAHB_(A) for MCL-1ΔNΔC binding at IC₅₀ potencies of <30 μM, we subjected 28 small molecules to dose-responsive target selectivity analysis in the comparative FITC-BID BH3/MCL-1ΔNΔC vs. FITC-BID BH3/BCL-X_(L)ΔC competition FP assay, and then to screening liposomal release and Bax^(−/−)Bak^(−/−) mouse embryonic fibroblasts (MEFs) cytotoxicity assays. Ultimately, we selected 4-((E)-(((Z)-2-(cyclohexylimino)-4-methylthiazol-3(2H)-yl)imino)methyl)benzene-1,2,3-triol, termed MCL-1 Inhibitor Molecule 1 (MIM1, FIG. 4), as our prototype compound due to a combination of favorable biophysical and biological properties that included MW>200, solubility, MCL-1 binding potency and selectivity, compatibility with and activity in a BAX-mediated liposomal release assay, and relatively little to no toxicity in Bax^(−/−)Bak^(−/−) MEFs.

The molecular structure of MIM1 (MW 347) is characterized by a thiazolyl core substituted with methyl, cyclohexylimino, and benzenetriol R groups (FIGS. 4 and 5). We chose to vet the anti-apoptotic binding selectivity of MIM1 in competitive FP assays by comparison with ABT-737, a selective BCL-2/BCL-X_(L) inhibitor molecule¹⁶. Whereas MIM1 effectively competed with FITC-MCL-1 SAHB_(A) and FITC-BID BH3 for MCL-1ΔNΔC binding with respective IC₅₀s of 4.7 and 4.8 μM, the compound showed no capacity to displace FITC-BID BH3 from BCL-X_(L)ΔC (IC₅₀>50 μM), mirroring the selectivity of Ac-MCL-1 SAHB_(D) (FIGS. 6A, 6B, and 6C). In striking contrast, ABT-737 competed with FITC-BID BH3 for BCL-X_(L)ΔC binding, but showed no activity toward MCL-1ΔNΔC. Although Ac-MCL-1 SAHB_(D) was a 30 to 60-fold more potent competitor for MCL-1 ΔNΔC binding than MIM1, the MCL-1-selective small molecule is one-seventh the size of the stapled peptide and exhibits an IC₅₀ for its target (4.8 μM) in the same range as that of ABT-737 for BCL-X_(L)ΔC (2.3 μM) upon competition with FITC-BID BH3. Thus, MIM1 emerged from the competitive screen with a marked MCL-1 ΔNΔC preference that reflects the binding specificity of the stapled peptide ligand and the opposite interaction profile of ABT-737.

Example 2 Structural Analysis of the MIM1/MCL-1ΔNΔC Interaction

To localize the protein interaction site that accounts for competitive small molecule binding activity, we performed NMR analysis of ¹⁵N-MCL-1ΔNΔC upon MIM1 titration. The addition of MIM1 up to a 2:1 molecule:protein ratio induced significant backbone amide chemical shift changes in those MCL-1 ΔNΔC residues concentrated in a subregion of the canonical BH3-binding pocket, which is comprised of residues from α2 (BH3) and portions of α3, α4, α5 (BH1) and α8 (BH2) (FIG. 7). These data are consistent with a direct interaction between MIM1 and MCL-1ΔNΔC at the very surface employed by BH3 helices to engage MCL-1.

We next performed molecular docking analysis to examine the predicted interactions between MIM1 and MCL-1 ΔNΔC at the BH3-binding pocket. Interestingly, MIM1 is predicted to occupy that portion of the BH3-binding site engaged by residues 211-216 ETLRRV (aa 211-216) of MCL-1 SAHB_(D) (FIG. 8, PDB 3MK8³⁴). Whereas the cyclohexyl group makes complementary hydrophobic contacts with the region of the protein interface flanked by MCL-1 SAHB_(D) residues L213 and V216, the thiazolyl core and its methyl substituent points directly into a deep crevice occupied in the MCL-1 SAHB_(D)/MCL-1ΔNΔC complex by the highly conserved leucine (MCL-1 SAHB_(D) L213) of BH3 domains. Interestingly, the benzene-1,2,3-triol (or pyrogallol) moiety engages in hydrophilic contacts with D256 and R263, two charged MCL-1 residues implicated in complementary electrostatic interactions with a variety of BH3 domain R/D pairs (e.g. aa R214, D218 of MCL-1 SAHB_(D)). Thus, MIM1 appears to simulate the key molecular features of approximately 1.5 turns of the MCL-1 BH3 helix at a potential selectivity hotspot on the MCL-1 binding surface.

Example 3 MIM1 Blocks MCL-1-mediated Suppression of Pro-Apoptotic BAX

We next examined whether MIM1 could selectively block MCL-1ΔNΔC -based suppression of BAX activation, as monitored by a BAX-mediated liposomal release assay tailored to distinguish between pharmacologic regulation by MCL-1 ΔNΔC vs. BCL-X_(L)ΔC. Whereas the BH3-only protein tBID directly triggers the transformation of monomeric BAX to a membrane-embedded oligomer that porates liposomal vesicles and releases encapsulated fluorophore, the addition of anti-apoptotic proteins, such as MCL-1ΔNΔC or BCL-X_(L)ΔC, blocks tBID-induced BAX activation and liposomal release (FIG. 9A). Whereas the BAX-suppressive effects of MCL-1 ΔNΔC are completely eliminated by pre-incubation with MCL-1 SAHB_(D), BCL-X_(L)ΔC-based inhibition of BAX activation is unimpeded by the MCL-1 selective stapled peptide (FIG. 9B). Conversely, ABT-737, which selectively blocks BCL-X_(L)ΔC, negates BCL-X_(L)ΔC-mediated suppression of BAX activation but has no effect on MCL-1ΔNΔC activity (FIG. 9C). Having documented the high fidelity of this tailored liposomal assay for distinguishing between anti-apoptotic selectivities, we next evaluated the functional activity of MIM1. Indeed, we find that MIM1 simulates the pharmacologic activity of MCL-1 SAHB_(D), preventing BAX suppression by MCL-1ΔNΔC but not by BCL-X_(L)ΔC (FIG. 9D). Consistent with the reduced molecular weight and competitive binding activity of MIM1 compared to MCL-1 SAHB_(D), the kinetics of MIM1 inhibition of MCL-1 ΔNΔC-mediated BAX suppression are correspondingly slower (FIG. 6A, FIG. 6B, FIG. 9B, FIG. 9D). Thus, these data explicitly link the selective MCL-1 ΔNΔC binding activity of MIM1 with functional blockade of MCL-1 ΔNΔC-mediated inhibition of BAX activation.

Example 4 Selective Activation of MCL-1-dependent Leukemia Cell Death by MIM1

A challenges in developing and applying molecular antagonists for BCL-2 family anti-apoptotic proteins is the variable expression of multiple homologues. That is, a cancer cell will only be susceptible to a selective anti-apoptotic inhibitor if the cell is especially dependent on that particular survival protein. Thus, the mere expression of MCL-1 does not necessarily predict cancer cell sensitivity to an MCL-1 selective inhibitor, as other anti-apoptotics lying outside its binding spectrum may continue to effectively suppress BAX/BAK. To test MIM1's activity and specificity in cancer cells, we employed murine p185⁺Arf^(−/−)Mcl-1^(−/−) chronic myelogenous leukemia (CML) cells that are unable to survive unless reconstituted with MCL-1, reflecting a stringent system for assessing MCL-1 dependence. To validate the cellular assay, we first compared the effect of ABT-737 on p185⁺Arf^(−/−)Mcl-1^(−/−) cells rescued by overexpression of MCL-1 or BCL-X_(L), and observed dose-responsive impairment of cancer cell viability (IC₅₀, 1.6 μM) that coincided with dose-responsive caspase 3/7 activation in the BCL-X_(L)-dependent cells, but no effect on the MCL-1-dependent cells (see FIGS. 11-12). Strikingly, MIM1 had the exact opposite effect, negatively impacting the viability of the MCL-1-dependent cells (IC₅₀, 4.2 μM), including dose-dependent induction of caspase 3/7 activity, but having little to no effect on the BCL-X_(L)-dependent cells (FIG. 4A-B). Importantly, ABT-737 and MIM1 had no significant effect on the viability of wild-type or Bax^(−/−)Bak^(−/−) MEFs over the same dose range, with no observed caspase 3/7 activation (FIGS. 15A-15D).

We next examined the functional impact of combining ABT-737 and MIM1 in isogenic p185⁺Arf^(−/−) cells differing only in their expression of MCL-1 and BCL-X_(L) (FIG. 10). In parental p185⁺Arf^(−/−) cells that express both MCL-1 and BCL-X_(L), the combination of ABT-737 (IC₅₀, 5.1 μM) and MIM1 (IC₅₀, 10.6 μM) resulted in synergistic cytotoxicity, as determined by CalcuSyn analysis³⁶ (IC₅₀, 1.4 μM; CI at ED₅₀, 0.47) (FIG. 13). Strikingly, when the combination was applied to MCL-1-reconstituted p185⁺Arf^(−/−)Mcl-1^(−/−) cells, the addition of ABT-737 had little effect (FIG. 14A). Similarly, the cytotoxic effects of single agent ABT-737 and the combination on BCL-X_(L)-reconstituted p185⁺Arf^(−/−)Mcl-1^(−/−) cells were identical, reflecting no added benefit of MIM1 in the absence of MCL-1 (FIG. 14B). These data underscore the selectivity of MIM1 and ABT-737 for their respective targets in the context of high stringency cancer cell dependence on MCL-1 or BCL-X_(L). Importantly, the relative resistance of non-malignant fibroblasts to MIM1 treatment, as previously observed for ABT-737²⁸, suggests that a therapeutic window may exist, with preferential toxicity to cells driven by discrete anti-apoptotic blockades.

Example 5 MCL-1 Binding Potency Correlates with the Degree of Cytotoxicity in MCL-1 Dependent Leukemia Cells

Medicinal chemistry-based optimization of MIM1 led to MIM1 analogs with increased MCL-1 binding potency (FIG. 16). A series of analogs with increased potency compared to MIM1 manifested increased cytotoxicity in MCL-1 dependent leukemia cells (FIG. 17). A series of compounds with variable potency in competitive binding to MCL-1ΔNΔC correspondingly manifested a degree of cytoxicity that correlated with MCL-1 binding affinity (FIG. 18).

Example 6 MIM1 Analogs with Dual Binding Activity Toward MCL-1 and BFL-1/A1

Some of the MCL-1 inhibitor compounds described herein, including MIM1, also bind tightly to BFL1/A1ΔC (FIGS. 16, 19, 20A, 21), which has been shown to be an important anti-apoptotic protein of the BCL-2 family and implicated in oncogenesis and chemoresistance. Thus, we provide examples of small molecules with dual specificity in targeting both the MCL-1 and BFL-1/A1 anti-apoptotic proteins.

Example 7 Selective Targeting of BFL-1/A1 by Distinct MIM1 Analogs

Some of the MIM1 analogs described herein (FIG. 20B) bind tightly to BFL1/A1ΔC (FIG. 22A) but show little to no interaction with MCL-1ΔNΔC (FIG. 22B), exemplifying compounds of the formula (I)/(II) that selectively target BFL-1/A1.

Example 8 Methods

SAHB Synthesis

Hydrocarbon-stapled peptides corresponding to BCL-2 family BH3 domains and their FITC-βAla derivatives were synthesized, purified, and characterized according to previously described methods^(19, 32, 37). The sequence compositions of all SAHBs used in this study are indicated in Table S1.

TABLE S1 (SEQ ID NOs: 1-6) Peptide Sequence N-terminus MW M/3 MCL-1 SA|HB_(A) KALETLRXVGDXVQRNHETAF FITC-βAla- 2893 965.5 MCL-1 SAHB_(D) KALETLRRVGDGVXRNHXTAF Acetyl-βAla- 2502 835.0 MCL-1 SAHB_(D) KALETLRRVGDGVXRHNHXTAF FITC-βAla- 2850 950.8 BAD SAHB_(A) NLWAAQRYGRELRXBSDXFVDSFKK Acetyl- 3090 1030.9 BID SAHB_(A) DIIRNIARHLAXVGDXBDRSI Acetyl- 2438 813.7 BCL-2 SAHB_(A) VVHLTRXAGDXFSRRY Acetyl- 2082 694.4

BCL-2 Family Protein Production

Recombinant MCL-1ΔNΔC, BCL-X_(L)ΔC, BFL-1/A1, and full-length BAX were expressed and purified as previously reported^(30,38). Transformed Escherichia coli BL21 (DE3) were cultured in ampicillin-containing Luria Broth, and protein expression was induced with 0.5 mM isopropyl β-D-1-thiogalactopyranoside (IPTG). The bacterial pellets were resuspended in buffer (1% Triton X-100 in PBS, complete protease inhibitor tablet for MCL-1ΔNΔC, BCL-X_(L)ΔC, and BFL-1/A1, and 250 mM NaCl, 20 mM Tris, complete protease inhibitor tablet, pH 7.2 for BAX), sonicated, and after centifugation at 45,000×g for 45 min, the supernatants were applied to glutathione-sepharose columns (GE Healthcare) for GST-MCL-1ΔNΔC, BCL-X_(L)ΔC, and BFL-1/A1, or a chitin column (BioLabs) for Intein-BAX. On-bead digestion of GST-tagged protein was accomplished by overnight incubation at room temperature in the presence of thrombin (75 units) in PBS (3 mL), whereas the intein tag was cleaved from BAX by overnight incubation of the chitin beads at 4° C. with 50 mM DTT. MCL-1ΔNΔC, BCL-X_(L)ΔC, and BFL-1/A1 were purified by size exclusion chromatography (SEC) using 150 mM NaCl, 50 mM Tris, pH 7.4 buffer conditions, and full-length monomeric BAX protein was isolated by SEC using a Superdex-75 column (GE Healthcare) using 20 mM HEPES pH 7.2, 150 mM KCl buffer conditions.

Fluorescence Polarization Binding Assays

Fluorescence polarization assays (FPA) were performed as previously described^(38,39). Briefly, direct binding curves were first generated by incubating FITC-MCL-1 SAHB_(A), FITC-BID BH3, or FITC-BAD BH3 (15 nM) with serial dilutions of anti-apoptotic protein, and fluorescence polarization measured at 5 minutes on a SpectraMax M5 microplate reader (Molecular Devices). For competition assays, a serial dilution of small molecule or acetylated peptide was added to recombinant protein at ˜EC₇₅ concentration, as determined by the direct binding assay (e.g. MCL-1 ΔNΔC, 45 nM; BCL-X_(L)ΔC, 300 nM). Fluorescence polarization was measured at equilibrium and IC₅₀ values calculated by nonlinear regression analysis of competitive binding curves using Prism software (Graphpad).

High-Throughput Screening

Small molecule screening was performed at the Institute for Chemistry and Cellular Biology (ICCB) at Harvard Medical School, utilizing the commercial libraries Asinexl (12,378 molecules), Chembridge3 (10,560 molecules), ChemDiv4 (14,677 molecules), Enamine2 (26,576), Life Chemicalsl (3,893 molecules), and Maybridge5 (3,212 molecules). High-throughput competitive FP binding assays were employed to screen for small molecules that disrupted the FITC-MCL-1 SAHB_(A)/MCL-1ΔNΔC, but not the FITC-BAD BH3/BCL-X_(L)ΔC, interaction. SEC-purified MCL-1ΔNΔC or BCL-X_(L)AC (see above) was delivered by automated liquid handler (WellMate, Matrix) to 384 well plates, followed by addition of small molecule libraries (˜5 mg/mL, 100 nL). After a 15 min incubation at room temperature, the corresponding FITC-SAHB (15 nM) was added to each well by liquid handler and FP read at 1 h using a PerkinElmer Envision plate reader (λ_(ex) 480 nm, λ_(em) 535 nm).

MIM1 Characterization by Mass Spectrometry and ¹H-NMR Spectroscopy

4-((E)-(((Z)-2-(cyclohexylimino)-4-methylthiazol-3(2H)-yl)imino)methyl)benzene-1,2,3-triol. LC-MS: 348 (M+1, ES+); 346 (M−1, ES−). ¹H NMR (300 MHz, DMSO-d6): d 11.35 (s, 1H, —OH); 9.3 (s, 1H, —OH); 8.42 (s, 1H, —OH); 8.31 (s, 1H); 6.73 (d, 1H, J=8.4 Hz); 6.34 (d, 1H, J=8.4 Hz); 6.01 (s, 1H); 3.09-3.05 (m, 1H); 2.15 (s, 3H); 1.81-1.60 (m, 5H); 1.40-1.2 (m, 3H), 1.15 (t, 2H).

NMR Samples and Spectroscopy

Uniformly ¹⁵N-labeled MCL-1 ΔNΔC was generated by modifying its expression and purification scheme in accordance with the method for producing ¹⁵N-BAX^(30,40) Protein samples were prepared in 20 mM HEPES solution at pH 6.5 in 5% D₂O. MIM1 (20 mM stock) was titrated into a solution of 100 μM MCL-1ΔNΔC to achieve the indicated molar ratio concentration. Correlation ¹H-¹⁵N HSQC spectra⁴¹ were acquired at 25° C. on a Bruker 800 MHz NMR spectrometer equipped with a cryogenic probe, processed using NMRPipe⁴², and analyzed with NMRView⁴³. The weighted average chemical shift difference Δ at the indicated molar ratio was calculated as √{square root over ({(ΔH)²+(ΔN/5)² }/2)} in p.p.m. The absence of a bar indicates no chemical shift difference, or the presence of a proline or residue that is overlapped or not assigned. MCL-1ΔNΔC cross-peak assignments were applied as previously reported⁴⁰. The significance threshold for backbone amide chemical shift changes was calculated based on the average chemical shift across all residues plus the standard deviation, in accordance with standard methods⁴⁴.

Structure Modeling

Docked structures of MCL-1ΔNΔC and MIM1 were generated using Glide and analyzed using PYMOL⁴⁵.

Liposomal Release Assay

Liposomes were prepared and release assays performed as previously described^(46,47). Liposomal composition reflects a mixture of the following molar percentages of lipids (Avanti Polar Lipids): phosphatidylcholine, 48%; phosphatidylethanolamine, 28%; phosphatidylinositol, 10%; dioleoyl phosphatidylserine, 10%; and tetraoleoyl cardiolipin, 4%. Aliquots of mixed lipids (1 mg total) are stored in glass at −20° C. under nitrogen, and before use, resuspended in liposome assay buffer (10 mM HEPES, 200 mM KCl, 1 mM MgCl₂, pH 7) containing 12.5 mM of the fluorescent dye ANTS (8-aminonaphthalene-1,3,6-trisulfonic acid, disodium salt) and 45 mM of the quencher DPX (p-xylene-bis-pyridinium bromide. The resulting slurry is vortexed for 10 min and freeze-thawed five times in liquid nitrogen and a 40° C. water bath, respectively. The solution is then passed through an Avanti Mini-Extruder Set (#610000) equipped with a 100 nm filter, followed by passage through a Sepharose column (GE Healthcare) to remove residual ANTS/DPX. The liposomes are brought up to a volume of 3 mL to produce a final liposome stock. For the liposomal release assay, a total volume of 30 μL is used in 384 well black flat-bottom plates (Costar), and baseline fluorescent measurements of 8 μL liposomes are made for 10 min using a Tecan Infinite M1000 (λ_(ex) 355 nm, λ_(em) 520 nm). Following the baseline read, recombinant anti-apoptotic protein, with or without pre-incubated small molecule or peptide, is added to the liposomes. Subsequently, 20 nM caspase-cleaved mouse BID (R&D systems) and 250 nM purified recombinant monomeric BAX is added, and fluorescence measurements are recorded each minute until the release measurements plateau, at which point the liposomes are quenched with 0.2% Triton X-100 (100% release). The percentage release of ANTS/DPX is calculated as percentage release=((F−F0)/(F100−F0))×100, where F0 and F100 are baseline and maximal fluorescence, respectively.

Cell Viability and Caspase 3/7 Activation Assays

p185⁺Arf^(−/−) and MCL-1 or BCL-X_(L)-rescued p185⁺Arf^(−/−)Mcl^(−/−) cells were maintained in RPMI 1640 (ATCC) supplemented with 10% (v/v) FBS, 100 U/mL penicillin, 100 μg/mL streptomycin, 0.1 mM MEM non-essential amino acids and 50 μM β-mercaptoethanol. Mouse embryonic fibroblasts (MEFs) cells were maintained in DMEM high glucose (Invitrogen) supplemented with 10% (v/v) FBS, 100 U/mL penicillin, 100 μg/mL streptomycin, 2 mM L-glutamine, 50 mM HEPES, 0.1 mM MEM non-essential amino acids and 50 μM β-mercaptoethanol. Leukemia cells (4×10⁴/well) were seeded in 96-well opaque plates and incubated with the indicated serial dilutions of vehicle (0.4% DMSO), MIM1, ABT-737, or the combination in DMEM at 37° C. in a final volume of 100 μl. For MEF experiments, cells (5×10³/well) were seeded in 96-well opaque plates for 24 h and then incubated with the indicated serial dilutions of vehicle (0.4% DMSO), MIM1, or ABT-737. Cell viability was assayed at 24 h by addition of CellTiter-Glo reagent according to the manufacturer's protocol (Promega), and luminescence was measured using a SpectraMax M5 microplate reader (Molecular Devices). Caspase 3/7 activation was assayed at 8 h by addition of Caspase-Glo 3/7 reagent according to manufacturer's protocol (Promega), and luminescence measured using a SpectraMax M5 microplate reader. Viability and caspase assays were performed in duplicate, repeated at least twice with independent cell cultures, and the data normalized to vehicle-treated control wells. Synergy of the MIM1/ABT-737 combination in leukemia cells was calculated using the CalcuSyn software package³⁶.

Example 9 Synthesis Examples Example A

The molecule 183-20 was synthesized according to the scheme (Scheme 1) shown below.

Procedure: A mixture of 4-phenylthiosemicarbazide 1 (100 mg, 0.6 mmol) and trihydroxy benzaldehyde 2 (93 mg, 0.6 mmol) in 4 mL absolute ethanol was refluxed in a sealed tube for 6 hours. The solvent was evaporated off and the residue was triturated with ether-hexane (1:1) mixture to afford the product 3 [143 mg, 79%; LC-MS: m/z 304 (M+1)]. This product was used for the next step without purification. A mixture of 3 (50 mg, 0.165 mmol) and chloroacetone 4 (153 mg, 1.65 mmol) was heated at 80° C. for 10 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and washed with dry ether (×3), dry THF (×1), hexane (×1) and dried under vacuum to afford the product 5 [42 mg, 68%; LC-MS: m/z 342 (M+1)] as HCl salt.

Example B

The molecule 183-84 was synthesized according to the scheme (Scheme 2) shown below.

Procedure: A mixture of 4-cyclohexylthiosemicarbazide 6 (150 mg, 0.87 mmol) and trihydroxy benzaldehyde 7 (134 mg, 0.87 mmol) in 5 mL absolute ethanol was refluxed in a sealed tube for 8 hours. The solvent was evaporated off and the residue was triturated with ether-hexane (1:1) mixture to afford the product 8 [210 mg, 78%; LC-MS: m/z 310 (M+1)]. This product was used for the next step without purification. A mixture of 8 (50 mg, 0.16 mmol) and chloroacetone 4 (150 mg, 1.62 mmol) was heated at 80° C. for 10 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and washed with dry ether (×3), dry THF (×1), hexane (×1) and dried under vacuum to afford the product 9 [35 mg, 56%; LC-MS: m/z 348 (M+1)] as HCl salt.

Example C

The molecule 190-20 was synthesized according to the scheme (Scheme 3) shown below.

Procedure: A mixture of 3 (75 mg, 0.25 mmol) and 2-bromo 1-cycloproyl ethanone 10 (202 mg, 1.25 mmol) was heated at 80° C. for 10 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and washed with dry ether (×3), dry THF (×2), hexane (×1) and dried under vacuum to afford the product 11 [77 mg, 69%; LC-MS: m/z 368 (M+1)] as HBr salt.

Example D

The molecule 183-91 was synthesized according to the scheme (Scheme 4) shown below.

Procedure: A mixture of 12 (100 mg, 0.323 mmol) and ethyl 2-chloro acetoacetate 13 (530 mg, 0.323 mmol) was heated at 80° C. for 30 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and dissolved in dry THF (4 mL). The reaction mixture was neutralized with saturated sodium bicarbonate to adjust the pH to 7. The crude product was adsorbed onto silica gel and subjected to column chromatography using 0-30% ethyl acetate in hexane to afford the product 14 [62 mg, 46%; LC-MS: m/z 420 (M+1)]

Example E

The molecule 183-76 was synthesized according to the scheme (Scheme 5) shown below.

Procedure: A mixture of 12 (50 mg, 0.161 mmol) and 2-bromo acetylthiophene 15 (165 mg, 0.807 mmol) was heated at 80° C. for 10 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and dissolved in dry THF (3 mL). The reaction mixture was neutralized with saturated sodium bicarbonate to adjust the pH to 7. The crude product was adsorbed onto silica gel and subjected to column chromatography using 0-30% ethyl acetate in hexane to afford the product 16 [34 mg, 51%; LC-MS: m/z 416 (M+1)].

Example F

The molecule 187-58 was synthesized according to the scheme (Scheme 6) shown below

Procedure: A mixture of 17 (50 mg, 0.122 mmol) and bromo compound 18 (165 mg, 0.49 mmol) was heated at 80° C. for 10 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and dissolved in dry THF (3 mL). The reaction mixture was neutralized with saturated sodium bicarbonate to adjust the pH to 7. The crude product was adsorbed onto silica gel and subjected to column chromatography using 0-60% ethyl acetate in hexane to afford the product 19 [21 mg, 35%; LC-MS: m/z 489 (M+1)]. This product was treated with trifluoroacetic acid to obtain the product 20 [7 mg, 42%; LC-MS: m/z 389 (M+1)].

Example G

The molecule 187-7 was synthesized according to the scheme (Scheme 7) shown below

Procedure: A mixture of 21 (50 mg, 0.162 mmol) and bromo compound 10 (131 mg, 0.81 mmol) was heated at 80° C. for 10 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and dissolved in dry THF (2 mL). The reaction mixture was neutralized with saturated sodium bicarbonate to adjust the pH to 7. The crude product was adsorbed onto silica gel and subjected to column chromatography using 0-30% ethyl acetate in hexane to afford the product 22 [27 mg, 48%; LC-MS: m/z 374 (M+1)].

Example H

The molecule 183-87 was synthesized according to the scheme (Scheme 8) shown below

Procedure: A mixture of 23 (60 mg, 0.19 mmol) and chloropinacolone 24 (156 mg, 1.16 mmol) was heated at 80° C. for 45 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and dissolved in dry THF (3 mL). The reaction mixture was neutralized with saturated sodium bicarbonate to adjust the pH to 7. The crude product was adsorbed onto silica gel and subjected to column chromatography using 0-30% ethyl acetate in hexane to afford the product 25 [36 mg, 48%; LC-MS: m/z 390 (M+1)].

Example I

The molecule 187-44 was synthesized according to the scheme (Scheme 9) shown below

Procedure: A mixture of 24 (75 mg, 0.24 mmol) and bromo compound 18 (213 mg, 1.21 mmol) was heated at 80° C. for 60 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and dissolved in dry THF (3 mL). The reaction mixture was neutralized with saturated sodium bicarbonate to adjust the pH to 7. The crude product was adsorbed onto silica gel and subjected to column chromatography using 0-30% ethyl acetate in hexane to afford the product 26 [41 mg, 44%; LC-MS: m/z 387 (M+1)].

Example J

The molecule 183-89 was synthesized according to the scheme (Scheme 10) shown below

Procedure: A mixture of 24 (50 mg, 0.162 mmol) and chloro butanone 27 (103 mg, 0.97 mmol) was heated at 80° C. for 60 minutes. LC-MS analysis indicated completion of the reaction. The reaction mixture was cooled to room temperature and washed with dry ether (×3), dry THF (×1), hexane (×1) and dried under vacuum to afford the product 28 [38 mg, 65%; LC-MS: m/z 362 (M+1)] as HCl salt.

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It is to be understood that while the invention has been described in conjunction with the detailed description thereof, the foregoing description is intended to illustrate and not limit the scope of the invention, which is defined by the scope of the appended claims. Other aspects, advantages, and modifications are within the scope of the following claims. 

What is claimed is:
 1. A pharmaceutical combination comprising a compound of formula (II), or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents selected from the group consisting of chemotherapeutic agents and therapeutic agents that modulate apoptosis, or a pharmaceutically acceptable salt of the agent:

wherein: R²² is: (i) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(a); (ii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(a); or (iii) phenyl fused to C₁-C₃ alkylenedioxy, wherein the phenyl portion is optionally substituted with from 1-2 independently selected R^(a); R²³ is: (i) C₃-C₈ branched alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); or (ii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); R²⁵ is: (i) hydrogen; (ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); (iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or (iv) —C(O)O(C₁-C₆ alkyl); or R²³ and R²⁵, together with the carbon atoms to which each is attached, form: (i) a 5-6 membered saturated or unsaturated carbocyclic ring, which is optionally substituted with from 1-4 independently selected R^(d); or (ii) a 5-6 membered saturated or unsaturated hetrocyclic ring, which is optionally substituted with from 1-4 independently selected R^(d), and wherein from 1-2 of the ring atoms (other than the two ring atoms attached to R²³ and R²⁴) is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached); or each of R²⁶ and R²⁷ is independently selected from the group consisting of hydrogen, halo, and hydroxyl; R²⁴ is: (i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); (ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c); (iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c); (iv) unsubstituted C₁-C₈ alkyl or unsubstituted C₁-C₈ haloalkyl; (v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d); (vi) (C₁-C₆ alkyl)-(C₃-C₈ cycloalkyl), wherein the cycloalkyl portion is optionally substituted with from 1-4 independently selected R^(d); or (vii) dihydronaphthyl, tetrahydronaphthyl, indanyl, or indenyl; R^(a) at each occurrence is, independently, selected from the group consisting of halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂; R^(b) at each occurrence is, independently, selected from the group consisting of hydroxyl, C₁-C₆ alkoxy; C₁-C₆ thioalkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NH₂; —NH(C₁-C₆ alkyl); N(C₁-C₆ alkyl)₂; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂; R^(c) at each occurrence is, independently, any one of the substituents delineated collectively in (a), (b), (c), and (d) below: (a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; (b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl); or —C(O)O—(CH₂)₁₋₃—C(O)-(phenyl optionally substituted as defined in (d) below; (c) L-C₃-C₈ cycloalkyl, C₃-C₆ cycloalkoxy, or L-heterocyclyl containing from 5-7 ring atoms, wherein from 1-2 of the ring atoms of the heterocyclyl is independently selected from the group consisting of N, NH, N(C₁-C₆ alkyl), NC(O)(C₁-C₆ alkyl), NC(O)O(C₁-C₆ alkyl), O, and S; and each of said ring systems is optionally substituted with from 1-3 independently selected C₁-C₄ alkyl groups; and wherein L is a bond or C₁-C₆ alkylene; and (d) phenyl, —O-(phenyl), or heteroaryl containing from 5-6 ring atoms, wherein from 1-2 of the ring atoms of the heteroaryl is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), O, and S; wherein each of said phenyl and heteroaryl is optionally substituted with from 1-3 substituents independently selected from the group consisting of halo; hydroxyl; cyano; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); nitro; —NH₂; —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, —NHC(O)(C₁-C₆ alkyl), C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, and C₁-C₆ haloalkyl, wherein said alkyl or alkyl portion is optionally substituted with —OH, —NH₂, or —SH; R^(d) at each occurrence is, independently, any one of the substituents delineated collectively in (a) and (b) below: (a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; or (b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), or —NHSO₂(C₁-C₆ alkyl).
 2. The composition of claim 1, wherein R²⁶ and R²⁷ together are a bond.
 3. The composition of claim 1, wherein R²² is C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(a).
 4. The composition of claim 1, wherein each R^(a) is independently selected from the group consisting of halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); and C(O)OH.
 5. The composition of claim 1, wherein one, two, or three of the independently selected R^(a) are hydroxyl.
 6. The composition of claim 1, wherein R²³ is: (i) C₃-C₆ cycloalkyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or (ii) C₃-C₈ branched alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b).
 7. The composition of claim 1, wherein R²⁵ is hydrogen.
 8. The composition of claim 1, wherein R²⁵ is C₁-C₈ alkyl, which is optionally substituted with from 1-2 independently selected R^(b).
 9. The composition of claim 1, wherein R²⁴ is: (i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); (ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c); (iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c); or (iv) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d).
 10. A compound of formula (II), or a pharmaceutically acceptable salt thereof:

wherein: R²² is: (i) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(a); (ii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(a); or (iii) phenyl fused to C₁-C₃ alkylenedioxy, wherein the phenyl portion is optionally substituted with from 1-2 independently selected R^(a); R²³ is: (i) C₃-C₈ branched alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); or (ii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); R²⁵ is: (i) hydrogen; (ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); (iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or (iv) —C(O)O(C₁-C₆ alkyl); R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached); R²⁴ is: (i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or (ii) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d); R^(a) at each occurrence is, independently, selected from the group consisting of halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂; R^(b) at each occurrence is, independently, selected from the group consisting of hydroxyl, C₁-C₆ alkoxy; C₁-C₆ thioalkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NH₂; —NH(C₁-C₆ alkyl); N(C₁-C₆ alkyl)₂; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂; R^(c) at each occurrence is, independently, any one of the substituents delineated collectively in (a), (b), (c), and (d) below: (a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; (b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl); or —C(O)O—(CH₂)₁₋₃—C(O)-(phenyl optionally substituted as defined in (d) below; (c) L-C₃-C₈ cycloalkyl, C₃-C₆ cycloalkoxy, or L-heterocyclyl containing from 5-7 ring atoms, wherein from 1-2 of the ring atoms of the heterocyclyl is independently selected from the group consisting of N, NH, N(C₁-C₆ alkyl), NC(O)(C₁-C₆ alkyl), NC(O)O(C₁-C₆ alkyl), O, and S; and each of said ring systems is optionally substituted with from 1-3 independently selected C₁-C₄ alkyl groups; and wherein L is a bond or C₁-C₆ alkylene; and (d) phenyl, —O—(phenyl), or heteroaryl containing from 5-6 ring atoms, wherein from 1-2 of the ring atoms of the heteroaryl is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), O, and S; wherein each of said phenyl and heteroaryl is optionally substituted with from 1-3 substituents independently selected from the group consisting of halo; hydroxyl; cyano; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); nitro; —NH₂; —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, —NHC(O)(C₁-C₆ alkyl), C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, and C₁-C₆ haloalkyl, wherein said alkyl or alkyl portion is optionally substituted with —OH, —NH₂, or —SH; R^(d) at each occurrence is, independently, any one of the substituents delineated collectively in (a) and (b) below: (a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; or (b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl).
 11. The compound of claim 10, wherein R²² has formula (A)

wherein: three of R²²¹, R²²², R²²³, R²²⁴, and R²²⁵ are hydroxyl, and the others are hydrogen.
 12. The compound of claim 10, wherein R²⁵ is hydrogen or unsubstituted C₁-C₃ alkyl.
 13. The compound of claim 10, wherein R²³ is C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d).
 14. The compound of claim 10, wherein R²³ is branched C₃-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b).
 15. The compound claim 10, wherein R²⁴ is C₃-C₁₀ cycloalkyl, which is optionally substituted with from 1-4 independently selected R^(d).
 16. A compound or a pharmaceutically acceptable salt thereof, wherein the compound is selected from the group consisting of the compounds shown in the following table:


17. A pharmaceutical composition comprising a compound or salt according to claim 10 and a pharmaceutically acceptable carrier.
 18. A method for inhibiting MCL-1 and/or BFL-1/A1 comprising contacting MCL-1 and/or BFL-1/A1 with a compound or salt according to claim
 10. 19. A method for treating cancer comprising administering a compound or salt according to claim 10 to a subject in need thereof.
 20. A pharmaceutical composition comprising: a compound or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents; wherein the compound is selected from the group consisting of the compounds shown in the following table:


21. The compound of claim 16, wherein the compound is

or a pharmaceutically acceptable salt thereof.
 22. The composition of claim 20, wherein the compound is

or a pharmaceutically acceptable salt thereof.
 23. A pharmaceutical composition, comprising: a compound of formula (II) or a pharmaceutically acceptable salt thereof; and one or more additional therapeutic agents or a pharmaceutically acceptable salt of the agent:

wherein: R²² is: (i) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(a); (ii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(a); or (iii) phenyl fused to C₁-C₃ alkylenedioxy, wherein the phenyl portion is optionally substituted with from 1-2 independently selected R^(a); R²³ is: (i) C₃-C₈ branched alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); (ii) heteroaryl is optionally substituted with from 1-3 independently selected R^(c); (iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); R²⁵ is: (i) hydrogen; (ii) C₁-C₈ alkyl or C₁-C₈ haloalkyl, each of which is optionally substituted with from 1-2 independently selected R^(b); (iii) C₃-C₆ cycloalkyl or C₃-C₆ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); or (iv) —C(O)O(C₁-C₆ alkyl); or R²³ and R²⁵, together with the carbon atoms to which each is attached, form: (i) a 5-6 membered saturated or unsaturated carbocyclic ring, which is optionally substituted with from 1-4 independently selected R^(d); or (ii) a 5-6 membered saturated or unsaturated hetrocyclic ring, which is optionally substituted with from 1-4 independently selected R^(d), and wherein from 1-2 of the ring atoms (other than the two ring atoms attached to R²³ and R²⁴) is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; R²⁶ and R²⁷ together are a bond (form a second or double bond between the carbon atoms to which each is attached); or each of R²⁶ and R²⁷ is independently selected from the group consisting of hydrogen, halo, and hydroxyl; R²⁴ is: (i) C₃-C₁₀ cycloalkyl or C₃-C₁₀ cycloalkenyl, each of which is optionally substituted with from 1-4 independently selected R^(d); (ii) C₆-C₁₀ aryl, which is optionally substituted with from 1-5 independently selected R^(c); (iii) heteroaryl, which contains from 5-10 ring atoms, wherein from 1-4 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), O, and S; and wherein said heteroaryl ring is optionally substituted with from 1-4 independently selected R^(c); (iv) unsubstituted C₁-C₈ alkyl or unsubstituted C₁-C₈ haloalkyl; (v) heterocyclyl containing from 3-6 ring atoms, wherein from 1-2 of the ring atoms is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), NC(O)(C₁-C₆ alkyl), O, and S; and wherein said heterocyclyl is optionally substituted with from 1-3 independently selected R^(d); (vi) (C₁-C₆ alkyl)-(C₃-C₈ cycloalkyl), wherein the cycloalkyl portion is optionally substituted with from 1-4 independently selected R^(d); or (vii) dihydronaphthyl, tetrahydronaphthyl, indanyl, or indenyl; R^(a) at each occurrence is, independently, selected from the group consisting of halo, hydroxyl, C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂; R^(b) at each occurrence is, independently, selected from the group consisting of hydroxyl, C₁-C₆ alkoxy; C₁-C₆ thioalkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thiohaloalkoxy; —NH₂; —NH(C₁-C₆ alkyl); N(C₁-C₆ alkyl)₂; —NHC(O)(C₁-C₆ alkyl); cyano; —C(O)H; —C(O)(C₁-C₆ alkyl); —C(O)(C₁-C₆ haloalkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); and —SO₂N(C₁-C₆ alkyl)₂; R^(c) at each occurrence is, independently, any one of the substituents delineated collectively in (a), (b), (c), and (d) below: (a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; (b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), —NHSO₂(C₁-C₆ alkyl); or —C(O)O—(CH₂)₁₋₃—C(O)-(phenyl optionally substituted as defined in (d) below; (c) L-C₃-C₈ cycloalkyl, C₃-C₆ cycloalkoxy, or L-heterocyclyl containing from 5-7 ring atoms, wherein from 1-2 of the ring atoms of the heterocyclyl is independently selected from the group consisting of N, NH, N(C₁-C₆ alkyl), NC(O)(C₁-C₆ alkyl), NC(O)O(C₁-C₆ alkyl), O, and S; and each of said ring systems is optionally substituted with from 1-3 independently selected C₁-C₄ alkyl groups; and wherein L is a bond or C₁-C₆ alkylene; and (d) phenyl, —O-(phenyl), or heteroaryl containing from 5-6 ring atoms, wherein from 1-2 of the ring atoms of the heteroaryl is independently selected from the group consisting of N, NH, N(C₁-C₃ alkyl), O, and S; wherein each of said phenyl and heteroaryl is optionally substituted with from 1-3 substituents independently selected from the group consisting of halo; hydroxyl; cyano; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); nitro; —NH₂; —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, —NHC(O)(C₁-C₆ alkyl), C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, and C₁-C₆ haloalkyl, wherein said alkyl or alkyl portion is optionally substituted with —OH, —NH₂, or —SH; R^(d) at each occurrence is, independently, any one of the substituents delineated collectively in (a) and (b) below: (a) C₁-C₆ alkoxy; C₁-C₆ haloalkoxy; C₁-C₆ thioalkoxy; C₁-C₆ thiohaloalkoxy; C₁-C₆ alkyl, C₁-C₆ haloalkyl, —NH(C₁-C₆ alkyl), N(C₁-C₆ alkyl)₂, or —NHC(O)(C₁-C₆ alkyl), each of which is optionally substituted with —OH, C₁-C₆ alkoxy, —NH₂, or —SH; or (b) halo; —OH; —CN; nitro; —NH₂; azido; C₂-C₄ alkenyl; C₂-C₄ alkynyl; —C(O)H; —C(O)(C₁-C₆ alkyl); C(O)OH; —C(O)O(C₁-C₆ alkyl); —OC(O)(C₁-C₆ alkyl); —SO₂(C₁-C₆ alkyl); —SO₂(C₁-C₆ haloalkyl); —C(O)NH₂; —C(O)NH(C₁-C₆ alkyl); C(O)N(C₁-C₆ alkyl)₂; —SO₂(C₁-C₆ alkyl); —SO₂NH₂; —SO₂NH(C₁-C₆ alkyl); —SO₂N(C₁-C₆ alkyl)₂; —NHCO(C₁-C₆ alkyl), or —NHSO₂(C₁-C₆ alkyl). 